• Erica J Stein and David B Glick.
• aDepartment of Anesthesiology, Ohio State University, Columbus, Ohio bDepartment of Anesthesia and Critical Care, University of Chicago, Chicago, Illinois, USA.
• Curr Opin Anaesthesiol. 2016 Dec 1; 29 (6): 711-716.

Purpose Of ReviewInitial studies suggested that the use of processed electroencephalogram technology could significantly decrease the incidence of unintended intraoperative awareness events during general anesthesia. Subsequent work has cast doubts on these findings. This review will examine the current state of awareness monitoring.Recent FindingsRecently published randomized controlled trials examining the use of the bispectral index during general anesthesia have not been able to show superiority over other forms of monitoring depth of anesthesia, such as end-tidal anesthetic-agent concentration. Additionally, there is current interest in utilizing the unprocessed electroencephalogram to ascertain depth of anesthesia and recent studies have demonstrated its use in preventing postoperative delirium.SummaryAlthough awareness monitors such as the bispectral index monitor may have benefit in patients in whom volatile anesthetic agents must be minimized - such as in hemodynamically unstable patients, or patients undergoing total intravenous anesthesia - these monitors do not appear to be useful for all patients.

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