Journal of Yeungnam Medical Science

Case report

Awareness during general anesthesia despite simultaneous bispectral index and end-tidal anesthetic gas concentration monitoring: Jungwon Lee, Chorong Park, Saeyoung Kim; Yeungnam Univ J Med. 2019;36(1):50-53. Published online December 14, 2018; DOI: https://doi.org/10.12701/yujm.2019.00010

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Awareness during general anesthesia occurs in approximately 0.1–0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0–5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7–1.3 MAC, awareness during anesthesia occurred.

Citations

Citations to this article as recorded by

Depth of anaesthesia monitoring: updated evidence. Comment on Br J Anaesth 2023; 131: 196–9
Paul S. Myles
British Journal of Anaesthesia.2023; 131(5): e145. CrossRef
Impact of bispectral index monitoring on critical incidents rate in high-risk patients: a randomised controlled trial
N. V. Trembach
Kuban Scientific Medical Bulletin.2022; 29(1): 48. CrossRef
A Crossover Comparison of the Sensitivity and the Specificity between BIS and AEP in Predicting Unconsciousness in General Anesthesia
Haitao Yang, Guan Wang, Jinxia Gao, Jie Liu, Liang Zhao
Scientific Programming.2020; 2020: 1. CrossRef

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