• C Tirén, R E Anderson, G Barr, A Owall, and J G Jakobsson.
• Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Sweden.
• Anaesthesia. 2005 Feb 1;60(2):189-93.

AbstractThe lack of a gold standard complicates the evaluation and comparison of anaesthetic depth monitors. This randomised study compares three different depth-of-anaesthesia monitors during cardiopulmonary bypass (CPB) at 34 degrees C with fentanyl/propofol anaesthesia adjusted clinically and blinded to the monitors. Coronary artery bypass grafting patients (n = 21) were randomly assigned to all three possible paired combinations of three monitors: Bispectral Index (Aspect Medical), AAI auditory evoked potential (Danmeter), Entropy (Datex-Ohmeda). Indices were manually recorded every 5 min during CPB. Agreement between paired indices was classified as good, non-, or disagreement. Anaesthesia was classed as adequate, inadequate, or excessive according to recommended index values. Of the 255 paired indices recorded, 62% showed good agreement, 33% showed non-agreement, and 5% showed disagreement. Using good agreement between two monitors as a gold standard, a quarter of the measurements indicate inappropriate anaesthetic depth monitoring during CPB with clinically titrated anaesthetic depth.

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