Prevention of Intraoperative Awareness in a High-Risk Surgical Population

To Bis or not to Bis….the controversy continues.  A study reported in the New England Journal of Medicine (Avidan et al, August 18,2011) evaluated using BIS versus end tidal agent concentration in the prevention of intraoperative awareness.

In this study, 6041 patients were randomly assigned to either have BIS or end tidal agent to determine anesthetic depth.  After surgery patients were assessed regarding intraoperative awareness.

Findings were that the superiority of BIS was not established and fewer patients had awareness in the end tidal agent group than in the BIS group.

Click here for article

In the same issue of NEJM, an editorial by Gregory Crosby, MD reviews the evolution of patient monitoring with regard to awareness and cautions that end tidal agent in and of itself may not be the answer to the problem.

Click here for editorial

Review the original article and make a comment….to Bis or not to Bis, that is the question.

7 thoughts on “Prevention of Intraoperative Awareness in a High-Risk Surgical Population”

  1. I believe this is a topic that we often underestimate. Patients expect to not remember the surgery and the lawyers are happy to sue when they do. I’ll pay more attention to my end tidal agent.

  2. I enjoy the commentary on this web site. It’s nice to have a variety of clinical topics to consider. The potential for awareness is always there and we need every tool and trick possible to prevent it.

  3. I’ve been browsing online today for clinical topics in anesthesia. This is a topic that we should all consider on a daily basis. Awareness after anesthesia is never good for the patient or the anesthetist

  4. I appreciate your post, it is interesting and compelling. I have found my way here through Google, I shall get back once more 🙂

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