Using the Bispectral Index Monitor to Decrease the Incidence of Unintended Intraoperative Awareness in the High-Risk Population

Unintended intraoperative awareness is a traumatizing complication of general anesthesia. This negative outcome affects 0.1-0.2% of all patients undergoing general anesthesia. Patients at higher risk for this experience include those undergoing emergency surgery, traumas, cesarian sections, those on cardiopulmonary bypass, those with substance use disorder, and those undergoing total-intravenous anesthesia (TIVA). This high-risk population is affected by unintended intraoperative awareness 1% of the time. The bispectral index (BIS) monitor has been proposed as a tool to decrease the incidence of unintended intraoperative awareness. There are several large, randomized controlled trials that demonstrate that using a BIS monitor decreases the incidence of intraoperative awareness, but it is not a tool that is utilized for every anesthetic. This project aims to evaluate if using a BIS monitor for all high-risk patients will decrease the incidence of unintended intraoperative awareness in a large, central Ohio medical center. This project will include 100 high-risk, adult patients receiving general anesthesia at this medical center. Data will be collected by the project leader using the Modified Brice Interview as the measuring tool. The data collected will be reviewed by a team of three anesthesia experts and interpreted by a statistician for accuracy. The two possible outcomes of this project are: the patient experienced intraoperative awareness and the patient did not experience intraoperative awareness. The results of this project will be calculated to a percentage and compared to the national average of 1% to determine if the use of the BIS monitor decreases the incidence of intraoperative awareness in the high-risk patient population.