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British Journal of Anaesthesia, 2003, Vol. 91, No. 5 749-752
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Decreased bispectral index as an indicator of syncope before hypotension and bradycardia in two patients with needle phobia

N. N. Win, H. Kohase*, T. Miyamoto and M. Umino

Section of Anesthesiology and Clinical Physiology, Department of Oral Restitution, Division of Oral Sciences, Graduate School, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan 113-8549

Corresponding author: e-mail: hkohase.anph@tmd.ac.jp

We report two cases who exhibited a decrease in their bispectral index (BISTM) score, associated with syncope during venipuncture in patients with suspected needle phobia. In case 1, the reduction in BIS score occurred during the development of hypotension and bradycardia and may well have been caused by cerebral hypoperfusion. In case 2, the patient lost consciousness with decreasing BIS score before hypotension and bradycardia; this patient’s condition could not be completely explained by cerebral hypoperfusion as a result of a vasovagal reflex because the patient’s blood pressure and heart rate remained normal during the syncopal episode.

Br J Anaesth 2003; 91: 749–52


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