• Mallikarjunappa Satisha, Graeme M Sanders, Manikundalam R Badrinath, Joanna M Ringer, and Andrew P Morley.
• King's College Hospital, London, UK.
• Eur J Anaesthesiol. 2010 Feb 1;27(2):196-201.

Background And ObjectiveRandomized controlled trials have shown several beneficial effects of intraoperative bispectral index monitoring. We conducted a prospective audit to determine whether these could be replicated in everyday clinical practice.MethodsRecovery characteristics and drug costs from two 4-week periods were compared, immediately before (phase 1, n = 427 patients) and after (phase 2, n = 299 patients) the introduction of bispectral index monitoring in the main operating theatres of a district general hospital.ResultsDemographic and intraoperative variables for the two patient groups were similar. Nausea (P = 0.002), vomiting (P = 0.008) and antiemetic use (P = 0.001) in the postanaesthesia care unit all decreased in phase 2, though unrelated changes in antiemetic policy may have been partly responsible. Recovery time was unaffected. Drug costs decreased in phase 2 by an average of 0.86 pounds per patient. The cost of each semi-reusable sensor was 6.60 pounds.ConclusionIn a prospective audit, benefits of intraoperative bispectral index monitoring in our district general hospital were not seen to the same degree as in randomized controlled trials elsewhere.

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