Paradoxical Combinations of Bispectral Index and Burst Suppression Ratio
Authors' conclusion
BIS values are not continuously scaled, with some index values occurring distinctly more often. Paradoxical values of BIS between 40 and 60 and BSR≥5% can occur, potentially confusing anesthesia care providers.
Study context
- Population
- Patients aged 80.9 ± 5.8 (mean ± SD) years with intraoperative BIS and burst suppression ratio (BSR) recordings, BIS titrated to 40 to 60
- Participants
- 62 patients
- Outcome
- Distribution of BIS and BSR values and their relation, focusing on paradoxical situations (BIS 40 to 60 with BSR ≥ 5%): incidence rate and duration
Main finding
As reported in the abstract
Distribution of BIS and BSR values; paradoxical combinations
BIS values inside the 40 to 60 range despite titration to this range (median [Q1-Q3])
56.9 [44-74.2]%
Observational data: associations, not effects.
Original publication
Paradoxical Combinations of Bispectral Index and Burst Suppression Ratio. Anesth Analg. Published 23 December 2025. doi:10.
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