Improved Intraoperative Management of Patients Undergoing General Anesthesia
The goals of general anesthesia are to render the patient unconscious and to prevent pain during surgery. Until now there has not been a reliable way to directly assess the state of consciousness. Each year, however, it is estimated that 40,000-200,000 patients may experience awareness--the unintentional regaining of consciousness during a surgical procedure resulting from inadequate anesthesia. This problem can be difficult to detect visually because patients often are given neuromuscular blockers to prevent movement during surgery. As a result, patients may be awake and aware of events while under general anesthesia. They may also experience pain but at the same time be unable to communicate this feeling to the surgeon or anesthesiologist. These patients may suffer acute short-term and long-term negative effects, including post-traumatic stress disorder. To avoid the chance of patient awareness, anesthesiologists traditionally have tended to administer deep anesthesia reducing the potential for patient wake-up and prolonging recovery times.
Clinicians have worked to improve intraoperative management of patients under general anesthesia, but until recently they have been hindered in more accurately titrating anesthetic agents because of inadequate monitoring techniques. In 1996, however, Aspect Medical Systems (Natick, Mass.) introduced the A-1050TM EEG Monitor with the Bispectral IndexTM (BIS). The BIS provides anesthesiologists with a direct means of quantitatively measuring the effects of anesthetics on the brain, improving anesthetic delivery. Benefits associated with BIS monitoring include reduced anesthetic drug usage, faster wake-up times, and improved recovery for patients undergoing general anesthesia.
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