This position is supported by the scientific literature and independent experts, including the American Society of Anesthesiologists Task Force on
Intraoperative Awareness, which recently advised that brain function monitoring is not routinely indicated for patients undergoing general anesthesia.
Dr David Bogod, a consultant anaesthetist at Nottingham City Hospital, has written reports on
intraoperative awareness cases for a number of legal actions.
A consultant anaesthetist,Dr David Bogod,has written reports on
intraoperative awareness cases for a number of legal actions.
Practice advisory for
intraoperative awareness and brain function monitoring: a report by American Society of Anesthesiologists Task Force on
Intraoperative Awareness.
All those who completed the questionnaire (n = 48) stated that the anaesthesia had been satisfactory, while none reported
intraoperative awareness.
No patient reported
intraoperative awareness in the recovery room, or on days one or three after surgery.
The incidence of
intraoperative awareness has been reported as 1-2 cases per 1,000 under general anesthesia, according to the American Society of Anesthesiologists (ASA).
In terms of
intraoperative awareness, class 4 according to Mashour means:
Intraoperative awareness is a major medico-legal liability to the anaesthesiologists and can lead to postoperative psychosomatic dysfunction in the patient, and therefore should be avoided at all costs.
The potency and rapid onset of action of remifentanil is very appropriate for these cases, decreasing the risk of
intraoperative awareness and blunting the haemodynamic changes during surgery.
BIS-related research presented at the meeting of more than 5,000 anesthesiologists covers a broad spectrum of topics including short and long term outcome benefits of BIS monitoring,
intraoperative awareness and the role of fluctuations in BIS values in assessing pain both during and after surgery.
The use of cerebral monitoring for
intraoperative Awareness *
