Member Login

Request Password

Three large-scale clinical trials conducted in the United States and abroad evaluated more than 30,000 patients to investigate the incidence of awareness with recall and the impact of BIS monitoring on predicting and preventing awareness.

Incidence and adverse outcomes of awareness with recall in adults

• Research demonstrates that awareness with recall occurs in one to two patients per thousand receiving general anesthesia.^{1, 2, 3, 4}
• Prospective research shows that approximately 50% of patients that experience awareness with recall suffer psychological problems.⁵
• Awareness is a leading cause of patient dissatisfaction with anesthesia.⁶
• The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) issued a Sentinel Event Alert on preventing and managing the impact of anesthesia awareness.³

BIS: Reducing the incidence of awareness with recall in adults

Two prospective clinical studies have demonstrated that BIS monitoring can help clinicians reduce the incidence of awareness with recall by approximately 80%.^{7, 8} A third study that compared BIS-guided treatment to end-tidal anesthetic gas (ETAG) guided anesthesia showed that both interventions yielded a low risk of awareness (.21%).⁹ The "Practice Advisory for Intraoperative Awareness and Brain Function Monitoring" published in 2006 describes using multiple monitoring modalities "clinical techniques, conventional monitoring and brain function monitoring" to assess anesthetic depth and reduce the likelihood of intraoperative awareness. The Practice Advisory consensus opinion was that "the decision to use a brain function monitor should be made on a case-by-case basis by the individual practitioner for selected patients."⁴

 

 

 

References

• Sandin R, Enlund G. Awareness During Anesthesia:A Prospective Case Study.The Lancet 2000:Vol 355.
• Sebel PS, et al.The Incidence of Awareness During Anesthesia.A Multicenter United States Study.Anesth Analg. 2004; 99:833-9.
• JCAHO SEA (Issue No.32) "Preventing, and Managing the Impact of, Anesthesia Awareness", Oct 2004.
• Practice Advisory for Intraoperative Awareness and Brain Function Monitoring:A Report by the American Society of Anesthesiologists Task Force on Intraoperative Awareness.Anesthesiology. 2006;104:847-64.
• Lennmarken C, Bildfors K. Victims of Awareness.Acta Anaesthesiologica Scandinavica 2002; 46: 229-231.
• Myles P,Williams D. Patient Satisfaction After Anesthesia and Surgery: Results of a Prospective Survey of 10, 811 Patients. British Journal of Anaesthesia 2000; 84 (1).
• Myles PS, Leslie K. Bispectral Index Monitoring to Prevent Awareness During Anaesthesia:The B-Aware Randomised Controlled Trial.The Lancet 2004; 363: 1757-63.
• Ekman A, Lindholm ML, Lennmarken C, Sandin R. Reduction in the Incidence of Awareness Using BIS Monitoring.Acta Anaesthesiologica Scandinavica 2004; 48 (1): 20-6.
• Avidan M, et al. New England Journal of Medicine. 2008; 358:1097-108.

back to top

Copyright © 2009. Aspect Medical Systems. All Rights Reserved. Terms of Use | Privacy