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Question 2

What is Entropy?

Answer 2

It uses EEG and FEMG signals to determine the CNS state during anesthesia.

Question 3

How is entropy measured?

Answer 3

It measures the cortical electrical activity via EEG which becomes more regular with deeper anesthesia and FEMG quiets down as anesthetic is deepened.

Question 4

FEMG stands for?

Answer 4

Frontalis Electromyography

Question 5

BIS monitoring does what?

Answer 5

Monitors the effect of anesthetics in the brain

Question 6

Do you have to calibrate the BIS monitor?

Answer 6

NO

Question 7

Do the drugs given effect the patient and how they are monitored?

Answer 7

No they are independent of each other

Question 8

What are the 3 parts to the anesthesia triad?

Answer 8

Consciousness/Hipnosis, Analgesia, Muscle Realxation

Question 9

How do we measure how well we are managing analgesia for our patients?

Answer 9

Autonomic and Somatic Responses

Question 10

How do we evaluate how well our patients are muscle relaxed?

Answer 10

Train of 4

Question 11

How can we monitor our patients Consciousness?

Answer 11

BIS monitor

Question 12

BIS Range Guidelines: 0 - 39?

Answer 12

Deep hypnotic state, EEG supression

Question 13

BIS Range Guidelines: 40 - 60?

Answer 13

Moderate Hypnotic State

Question 14

BIS Range Guidelines: 61 - 70?

Answer 14

Light Hypnotic State

Question 15

BIS Range Guidelines: 71 - 100?

Answer 15

Awake, Light to Moderate Sedation

Question 16

BIS numbers less then what have a low probability of consciousness?

Answer 16

60

Question 17

BIS numbers less then what have a low probability of recall?

Answer 17

70

Question 18

Benefits of entropy monitoring?

Answer 18

Less drug utilization, faster wake up and extubation, More alert in PACU, Reduced PONV

Question 19

Estimated population aware during anesthesia?

Answer 19

1:1000

Question 20

Optimal Depth of Unconsciousness?

Answer 20

40-60 on the BIS

Question 21

Most important Reason to use a BIS monitor?

Answer 21

Effective monitoring for risk of awareness

Question 22

Can you use the BIS on the Left, RIght or both sides of the head?

Answer 22

Both

Question 23

Placement of the BIS

Answer 23

Circle 1- centered above the nose 2 inchesCircle 4- Above and adjacent to eyebrowCircle 3 - At the temple between the the corner of the eye and hairline

Question 24

The SQI number from 0-100 is an ________ of _________ obtained in the last 60 seconds.

Answer 24

Average of information

Question 25

The EMG may bias the BIS to a HIgher or Lower value?

Answer 25

Higher value

Question 26

Name two categories of drugs that lower the EMG (muscle tone)?

Answer 26

Analgesics and Hypnotics

Question 27

Name the 2 major sites that anesthetics work?

Answer 27

Brain and spinal cord

Question 28

Is BIS an anesthetic depth measurement?

Answer 28

NO, it's just one more piece of info on your patient to make a decision

Question 30

BIS response to Ketamine administrtion is

Answer 30

Atypical

Question 31

BIS response to anelgesia administration is dependent on

Answer 31

Level of stimulation

Question 32

BIS monitoring derives brain status from the EEG not?

Answer 32

The concerntation of a particular drug

Question 33

The BIS index valuse is calculated over how many seconds

Answer 33

15 -30 seconds

Question 34

BIS values may lag behind observed clinical changes by how long?

Answer 34

5-10 seconds

Question 35

EMG (forehead muscle tone) may increase or decrease BIS?

Answer 35

Increase

Question 36

During stable anesthesia without EMG artifact, Neuro muscular Blockers have little or no effect on the BIS?? True or False

Answer 36

True

Question 37

Ketamine may transiently increase BIS values due to EEG activation?? True or False

Answer 37

True

Question 38

Etomidate may transiently increase BIS?? True or False

Answer 38

True related to the drug induce myoclonus

Question 39

Which druge will increase the BIS value Phenelphrine or Ephedrine

Answer 39

Ephedrine Phenelephrine dose not

Question 40

Beta blockers and Alpha 2 Blockerswill cause and increase in the BIS value?? True or False

Answer 40

False they will cause a decrease in the BIS value

Question 41

If excessive EMG was noted on your patient prior to induction and a neuromuscular blocker was administered will ou have a steep incline or decline in the BIS value?

Answer 41

Steep decline because the BIS takes into account the EMG

Question 42

On what types of patients should a BIS monitor be used on?  

Answer 42

Previous episodes of awareness High opoid sedative tolerance Anticipated difficult airways Known to be hemodynamically unstable Surgical procedures with an increase risk of awareness

Question 43

There has been shown an 80% reduction in incidents of awarness when using the BIS monitor True or False

Answer 43

True

Question 44

Is Entropy different then BIS

Answer 44

Yes Bis measures mainly EEG giving you one number while Entropy measures Frontalis electromyography and EEG changes  

Question 45

EEG patterns change from irrgeular to regular with anesthetic depth?? Ture or False

Answer 45

True

Question 46

FEMG patterns increase with anesthetic depth True or Flase

Answer 46

False the Frontalis electromyography quiets down as the brain is saturated with anesthetic

Question 47

What does entropy measure?

Answer 47

The irregularity of the EEG and FEMG signals

Question 48

There are 2 entropy parameters what are they?

Answer 48

Response Entropy and State Entropy

Question 49

Response Entropy (RE) is sensitive to what?

Answer 49

facial muscle activation with in 2 seconds

Question 50

State Entropy (SE) is always less than or equal to what?

Answer 50

Response Entropy (RE)

Question 51

State Entropy is base on what?

Answer 51

The EEG signal

Question 52

Do NMB effect the EEG?

Answer 52

NO

Question 53

Are the BIS and Entorpy guidline ranges the same for conciousness?

Answer 53

YES 40-60 is where you want to be for no recall

Question 54

Entropy and BIS will help the CRNA with what?

Answer 54

Ensuring faster and more predictable wake ups Improving drug management Avoid unnecessary deep anesthesia prevent unexpected recovery

Question 55

What infulences the probability of awarness druing surgery?

Answer 55

ASA class 3-5 High opoid tolerence  

Question 56

What is the % of awake anesthetics in the US?

Answer 56

1-2 per 1000

Question 57

BIS reduces PONV by how much in ambulatory surgery

Answer 57

50%

Question 58

Does BIS reduce PACU stay?

Answer 58

Yes by 16%

Question 59

Less then 40 on the concious guidlines for BIS or Entropy means what

Answer 59

Deep Hypnotic State EEG suppression

Question 60

What is the most critical component of the BIS / Entropy System

Answer 60

Dual position versitility or right or left application

Question 61

EMG may bias the BIS to a higher value True or False

Answer 61

True

Question 62

Reliance on the BIS for intraoperative anesthetic managment alnoe is recommended?

Answer 62

HELL NO !!!!!