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|Title:||Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial.||Authors:||Myles, PS
|Issue Date:||May-2004||Source:||363(9423):1757-63.||Abstract:||BACKGROUND: Awareness is an uncommon complication of anaesthesia, affecting 0.1-0.2% of all surgical patients. Bispectral index (BIS) monitoring measures the depth of anaesthesia and facilitates anaesthetic titration. In this trial we determined whether BIS-guided anaesthesia reduced the incidence of awareness during surgery in adults. METHODS: We did a prospective, randomised, double-blind, multicentre trial. Adult patients at high risk of awareness were randomly allocated to BIS-guided anaesthesia or routine care. Patients were assessed by a blinded observer for awareness at 2-6 h, 24-36 h, and 30 days after surgery. An independent committee, blinded to group identity, assessed every report of awareness. The primary outcome measure was confirmed awareness under anaesthesia at any time. FINDINGS: Of 2463 eligible and consenting patients, 1225 were assigned to the BIS group and 1238 to the routine care group. There were two reports of awareness in the BIS-guided group and 11 reports in the routine care group (p=0.022). BIS-guided anaesthesia reduced the risk of awareness by 82% (95% CI 17-98%). INTERPRETATION: BIS-guided anaesthesia reduces the risk of awareness in at-risk adult surgical patients undergoing relaxant general anaesthesia. With a cost of routine BIS monitoring at US16 dollars per use in Australia and a number needed to treat of 138, the cost of preventing one case of awareness in high-risk patients is about 2200 dollars.||URI:||http://hdl.handle.net/11055/604||PubMed URL:||https://www.ncbi.nlm.nih.gov/pubmed/15172773||Study Name:||B-Aware Trial||Journal Title:||Lancet||Type:||Journal Article||Affiliates:||The Alfred Hospital||Study/Trial:||Randomized Controlled Clinical Trial/Controlled Clinical Trial|
|Appears in Collections:||Scholarly and Clinical|
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