Bispectral Index in Patients Undergoing Vertebral Surgery Using Artificial Intelligence Programs: A Methodological Study

The Bispectral Index (BIS) is an FDA-approved method for monitoring the depth of anesthesia. BIS combines time-domain, frequency-domain, and bispectral analysis of electroencephalography and is displayed as a dimensionless number between 0 (deep anesthesia) and 100 (awake); a value between 40 and 60 is suitable for surgical anesthesia. BIS shows good correlation with hypnotic state and anesthetic drug concentration, and its use can shorten recovery times. Recently, the use of artificial intelligence (AI) tools (Gemini 3.1, ChatCPT 5.5, Copilot 365 Premium) has become widespread in all fields. However, in the medical literature, there are only a limited number of recent studies that aim to enable emergency intervention in patients, increase clinical use, and obtain advice even if treatment recommendations are not available. Therefore, this study aims to interpret the BIS monitoring method, which we routinely use for monitoring in scoliosis surgery, with AI tools and to determine the accuracy and reliability of AI tools in clinical practice by comparing this interpretation with the interpretations of two clinicians experienced in BIS.

Inclusion criteria

• elective vertebra surgery
• aged 18-65
• ASA score I-III
• BMI <30 kg/m2

Exclusion criteria

• patient's refusal
• BMI >30 kg/m2
• serious liver or kidney disease
• ASA 4 ve more
• anatomical abnormality at probe site
• history of mental or neurological disease,
• history of previous intracranial aneurysm or intracranial tumor surgery
• history of moderate or severe pulmonary disease,
• emergency surgery