Navigation Links
New Technology No Better at Spotting 'Anesthesia Awareness'
Date:3/12/2008

Study comparing bispectral index monitoring to standard methods found little difference

WEDNESDAY, March 12 (HealthDay News) -- A much-touted technology designed to detect when patients are regaining consciousness while under anesthesia during surgery doesn't appear to work any better than standard methods.

Bispectral index (BIS) monitoring did not lower the incidence of "anesthesia awareness" in a large sample of patients, concluded a study from Washington University researchers that is published in the March 13 issue of the New England Journal of Medicine.

"We're left with the way we've done it in the past, that is using clinical signs of movement, high blood pressure, tachycardia, that kind of thing," said Dr. Gary H. Morton, an associate professor of anesthesiology at Texas A&M Health Science Center College of Medicine and vice chairman of anesthesiology at Scott & White in Temple. "The problem with any of these techniques is they're not 100 percent."

"This study is not showing any improvement in doing a better job of maintaining a lack of consciousness than the standard methods," added Gerald Frye, the Joseph H. Shelton professor of neuropharmacology and neurotoxicology in the department of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine.

But this doesn't necessarily close the door to using the system in the future.

"I don't think that this particular study says the BIS monitors are no good," Morton said. "It basically says they're not consistently better than what we have. Even an ASA [American Society of Anesthesiologists] practice advisory says that the BIS monitor may still be helpful in high-risk patients. We need to individualize the way we use them."

"No single study provides a definitive answer," said study author Dr. Michael Avidan, division chief of cardiothoracic anesthesia and cardiothoracic intensive care at Washington University School of Medicine in St. Louis. "Our study adds some interesting information and raises some interesting questions, including why is technology adopted so enthusiastically before there is compelling scientific evidence. . . Our study certainly drives the need for larger studies."

According to an accompanying editorial, more than 21 million patients in North America receive general anesthesia each year, and as many as one or two in every 1,000 may experience some awareness during a procedure. Awareness is more common in patients who have received neuromuscular-blocking drugs, making it impossible for them to communicate their distress.

One patient, undergoing surgery to remove her right eye, heard the surgeon speak to the resident. When she realized she was awake, she tried frantically to blink her eyes and move her head, to no avail. "I was screaming at the top of my lungs, but no noise was coming out," she recalled.

The phenomenon can lead to long-term psychological consequences, even post-traumatic stress disorder.

The FDA-approved bispectral index system leads a growing market in devices promising to reduce anesthesia awareness. It is used in about 60 percent of all operating rooms in the United States yet, according to the study authors, evidence on its utility is scant.

"It works by recording information from an EEG on electrical activity in our brain," explained Avidan. "The type of electrical activity that our brain has is different when it's awake or asleep. This monitors electrical activity from the frontal area of the brain and analyzes the wave form."

For this study, 2,000 patients undergoing general (inhaled) anesthesia were randomly assigned to BIS-guided anesthesia or to conventional anesthesia. They were then assessed for anesthesia awareness at 0 to 24 hours after the procedure, 24 to 72 hours after, and 30 days after.

Two patients experienced definite anesthesia awareness in each group, an overall incidence of 0.21 percent. Five more patients (four in the BIS group and one in the control group) had possible awareness.

The device may be of benefit to patients receiving intravenous anesthesia, which is used in a minority of surgical procedures and which is considered to be a risk factor for anesthesia awareness, the authors stated.

One of the problems is that administering anesthesia is such a finely calibrated, delicate procedure that other important variables need to be taken into account.

"It's sort of like flying an airplane. There are a lot of dials to look at," Frye said. "Maintaining proper air speed is important in flying and, in anesthesia, sometimes you have to lower the depth of the anesthesia to maintain stable vital signs in the patient."

More information

For more information, visit the Anesthesia Awareness Campaign, founded by a patient who experienced the phenomenon.



SOURCES: Michael S. Avidan, M.B., B.Ch., associate professor, anesthesiology and surgery, and division chief, cardiothoracic anesthesia and cardiothoracic intensive care, Washington University School of Medicine, St. Louis; Gerald Frye, Ph.D., Joseph H. Shelton professor, neuropharmacology and neurotoxicology, department of neuroscience and experimental therapeutics, Texas A&M Health Science Center College of Medicine; Gary H. Morton, M.D., associate professor, anesthesiology, Texas A&M Health Science Center College of Medicine, and vice chairman, anesthesiology, Scott & White, Temple, Texas; March 13, 2008, New England Journal of Medicine


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Virtual reality and computer technology improve stroke rehabilitation
2. Advanced Technology in Dental Imaging Benefits Patients
3. Precyse Solutions Promotes Ken Lacy to Senior Vice President & CIO to Drive Advancement of PrecyseNet(TM), Precyses Advanced Technology Solution
4. Vendormate Again Selected as Top 40 Georgia Innovative Technology Company
5. Breakthrough Seating Technology, ergoSEET(TM), Now Available in Indianapolis
6. Hill-Rom Selects NanoHorizons to Provide Antimicrobial Protection for Hill-Rom Products Using Nanotechnology
7. Independent Survey Names CyberKnife(R) System Most Widely Used Extracranial Radiosurgery Technology
8. Champions Biotechnology, Inc. Reports Two Cents per Share Earnings for Three Quarters Ended January 31, 2008
9. Civista Health Inc. Selects Phoenix Health Systems for Information Technology Outsourcing Services
10. Smith & Nephew Announces Breakthrough VERILAST(TM) Technology
11. Palomar Seeks to License Additional Companies to Home-Use Light-Based Hair Removal Technology
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
New Technology No Better at Spotting 'Anesthesia Awareness' 
(Date:2/13/2016)... ... ... DDi , a Makro company, makes it to ... in eClinical Solutions. DDi has built its solution competency with a unique blend ... DDi provides smarter technology for Clinical Development, Regulatory and Enterprise domains by providing ...
(Date:2/12/2016)... , ... February 12, 2016 , ... ... devoted exclusively to funding innovative lymphoma research and serving the lymphoma community through ... over 250 members of South Florida’s philanthropic community at its 10th anniversary Fashion ...
(Date:2/12/2016)... ... 2016 , ... Coco Libre, the maker of coconut water beverages with a ... Lounge Event. Coco Libre will offer musicians and celebrities the company’s signature Organic Coconut ... invitation-only gifting suite, held this year at the W Hollywood Hotel, has become a ...
(Date:2/12/2016)... ... February 12, 2016 , ... Fisher House Foundation Chairman ... John J. Lee, Nevada Military Support Alliance president Scott Bensing, and Peggy Kearns Director, ... VA Southern Nevada Healthcare System. This will be the first Fisher House in ...
(Date:2/12/2016)... ... February 12, 2016 , ... Young ... area, celebrates the beginning of the latest charity campaign in their community enrichment ... art. Donations to this worthy cause are currently being accepted at: http://artexpressioninc.org/ ...
Breaking Medicine News(10 mins):
(Date:2/12/2016)... , Kalifornien, 12. Februar 2016  Sequent ... der Aufnahme von Patienten für eine Studie zur ... Aneurysmen („WEB") speziell für die Behandlung von rupturierten ... , MD, Leiter der Neuroradiologie an der Universitätsklinik ... und Hauptprüfarzt der CLARYS-Studie hat den ersten Patienten ...
(Date:2/12/2016)... , Feb. 12, 2016  Eli Lilly and Company ... Court decided the Alimta® (pemetrexed disodium) vitamin regimen patent would ... the UK, France , Italy ... to dilute the product only with dextrose solution.  ... 2015, the UK Court of Appeal held that Lilly,s patent ...
(Date:2/12/2016)... BUDAPEST , Ungarn, February 12, 2016 ... ein Medizintechnikunternehmen, das sich auf den ungedeckten ... gab heute positive Ergebnisse seines klinischen Forschungsprogramms ... und Asthma-Patienten beschäftigt, ergab Verbesserungen ihrer respiratorischen ... Indiso ltd , ein Medizintechnikunternehmen, das ...
Breaking Medicine Technology: