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Created November 6, 2016, last updated over 8 years ago.
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Knowledge, pearl, summary or comment to share?Collected Articles
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Researchers induced awake paralysis in 10 volunteers using separately both suxamethonium and rocuronium. Both the BIS A2000 (2003) and BIS Vista monitor (2013) were tested.
BIS decreased immediately after paralysis and did not fully recover until muscle recovery. BIS values decreased to as low as 44, despite the subject being awake.
In more than half of the 20 trials the BIS value decreased to below 60 at some point. In one case this lasted for almost 4 minutes, representing 76% of the total paralysis time for that subject.
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Anesthesia and analgesia · May 2014
Randomized Controlled Trial Multicenter StudyA pilot study for a prospective, randomized, double-blind trial of the influence of anesthetic depth on long-term outcome.
Greater depth of anaesthesia may be associated with a higher incidence of wound infection, mortality and composite risk of complications.
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Anesthesia and analgesia · Aug 2015
Randomized Controlled Trial Multicenter Study Comparative StudyRationale and Design of the Balanced Anesthesia Study: A Prospective Randomized Clinical Trial of Two Levels of Anesthetic Depth on Patient Outcome After Major Surgery.
An association between relatively deep anesthesia, as guided by the bispectral index (BIS), and increased postoperative mortality has been demonstrated in 6 of 8 published observational studies, but association does not necessarily mean causality. Small clinical trials of anesthetic depth have demonstrated increased delirium and postoperative cognitive dysfunction in patients who were relatively deeply anesthetized, but have been inadequately powered to study mortality. A large-scale randomized study is required to determine whether causality exists. ⋯ This randomized controlled trial should definitively answer the question of whether titrating anesthetic depth makes a difference to patient outcome in a vulnerable patient group.
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