To Bis or not to Bis….the controversy continues. A study reported in the New England Journal of Medicine (Avidan et al, August 18,2011) evaluated using BIS versus end tidal agent concentration in the prevention of intraoperative awareness.
In this study, 6041 patients were randomly assigned to either have BIS or end tidal agent to determine anesthetic depth. After surgery patients were assessed regarding intraoperative awareness.
Findings were that the superiority of BIS was not established and fewer patients had awareness in the end tidal agent group than in the BIS group.
In the same issue of NEJM, an editorial by Gregory Crosby, MD reviews the evolution of patient monitoring with regard to awareness and cautions that end tidal agent in and of itself may not be the answer to the problem.
Review the original article and make a comment….to Bis or not to Bis, that is the question.