An exploratory study of the bilateral bispectral index for pain detection in traumatic-brain-injured patients with altered level of consciousness

Caroline Arbour, Céline Gélinas, Carmen G Loiselle, Patricia Bourgault

Introduction

Many patients with a traumatic brain injury (TBI) cannot communicate because of altered level of consciousness. Although observation of pain behaviors (e.g., frowning) is recommended for pain assessment in nonverbal populations, they are attenuated and sometimes even suppressed in patients with TBI receiving high doses of sedatives. This study explored the potential utility of the bilateral bispectral index system (BIS) for pain detection in critically ill adults with TBI and altered level of consciousness.