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New Technology No Better at Spotting 'Anesthesia Awareness'
Study comparing bispectral index monitoring to standard methods found little difference
By Amanda Gardner HealthDay Reporter
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WEDNESDAY, March 12 (HealthDay News) -- A much-touted technology designed to detect when patients are regaining consciousness while under anesthesia during surgery doesn't appear to work any better than standard methods.
Bispectral index (BIS) monitoring did not lower the incidence of "anesthesia awareness" in a large sample of patients, concluded a study from Washington University researchers that is published in the March 13 issue of the New England Journal of Medicine.
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"We're left with the way we've done it in the past, that is using clinical signs of movement, high blood pressure, tachycardia, that kind of thing," said Dr. Gary H. Morton, an associate professor of anesthesiology at Texas A&M Health Science Center College of Medicine and vice chairman of anesthesiology at Scott & White in Temple. "The problem with any of these techniques is they're not 100 percent."
"This study is not showing any improvement in doing a better job of maintaining a lack of consciousness than the standard methods," added Gerald Frye, the Joseph H. Shelton professor of neuropharmacology and neurotoxicology in the department of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine.
But this doesn't necessarily close the door to using the system in the future.
"I don't think that this particular study says the BIS monitors are no good," Morton said. "It basically says they're not consistently better than what we have. Even an ASA [American Society of Anesthesiologists] practice advisory says that the BIS monitor may still be helpful in high-risk patients. We need to individualize the way we use them."
"No single study provides a definitive answer," said study author Dr. Michael Avidan, division chief of cardiothoracic anesthesia and cardiothoracic intensive care at Washington University School of Medicine in St. Louis. "Our study adds some interesting information and raises some interesting questions, including why is technology adopted so enthusiastically before there is compelling scientific evidence. . . Our study certainly drives the need for larger studies."
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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 3/12/2008
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SOURCES: Michael S. Avidan, M.B., B.Ch., associate professor, anesthesiology and surgery, and division chief, cardiothoracic anesthesia and cardiothoracic intensive care, Washington University School of Medicine, St. Louis; Gerald Frye, Ph.D., Joseph H. Shelton professor, neuropharmacology and neurotoxicology, department of neuroscience and experimental therapeutics, Texas A&M Health Science Center College of Medicine; Gary H. Morton, M.D., associate professor, anesthesiology, Texas A&M Health Science Center College of Medicine, and vice chairman, anesthesiology, Scott & White, Temple, Texas; March 13, 2008, New England Journal of Medicine
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