BIS™ Brain Monitoring: It's Personal

Everything you need to help tailor your anesthesia procedures for improved outcomes.1

Overview
Drug Titration
Outcomes
Incidence

Overview

BIS™ monitoring provides an objective measure of the patient’s depth of consciousness, and combined with your experience, enables you to confidently monitor and tailor safe, optimal anesthesia for each patient.

Patient-Specific Drug Titration

Transforming Anesthesia Delivery—One Patient at a Time

Studies have shown reductions in the use of anesthetic drugs by as much as 50% in patients monitored with BIS™ technology:

  • BIS™ Monitoring enabled a 50% reduction in propofol administration during hypothermic cardiopulmonary bypass1
  • End-tidal desflurane concentration was reduced by 25% compared with standard anesthesia-monitoring practice2
  • Titration of isoflurane using the BIS™ index decreased use of isoflurane and contributed to faster emergence of elderly patients undergoing elective knee or hip replacement surgery3
  • For asleep-awake craniotomy procedures, where titratable anesthesia is preferred to facilitate more predictable intraoperative wake-up, BIS™ monitoring can provide further information to guide drug administration and predict responsiveness.4

Improved Emergence, Recovery and Discharge

Proven BIS™ Monitoring Outcomes

Optimal anesthetic administration improves patient outcomes and satisfaction, and may facilitate faster recovery and discharge by minimizing side effects and postoperative complications. Studies have shown that patients whose anesthetic dosing was guided by BIS™ monitoring required less anesthetic drug and experienced:

  • Faster extubation.1,2
  • Faster emergence.1
  • Better orientation at the post-anesthesia care unit (PACU).1
  • Faster discharge.1,2

Reduced Incidence of Awareness

BIS™ Monitoring—Reliable, Proven

Studies show an 80% reduction in awareness has been demonstrated when using BIS™ monitoring compared to routine care in both intravenous (TIVA, total intravenous anesthesia) and inhaled drug combinations in anesthesia patients.1-3

With TIVA procedures, the incidence of awareness can be 5-10 times greater than with inhaled anesthetics as a result of the short-acting nature of some intravenous anesthetics used, along with the challenges of monitoring the patient’s level of consciousness. This is all the more reason that BIS™ monitoring is important—it may help reduce the incidence of awareness during TIVA procedures and during inhaled anesthesia.4

References:

1. Gan TJ, Glass PS, Windor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS™ Utility Study Group. Anesthesiology. 1997;87(4):808-815.

2. National Institute for Health and Clinical Excellence. Depth of anaesthesia monitors (E-Entropy, BIS™ and Narcotrend) (DG6). November 2012. Available at: http://guidance.nice.org.uk/DG6.

3. Punjasawadwong Y, Phongchiewboon A, Bunchungmongkol N. Bispectral index for improving anaesthetic delivery and postoperative recovery. Cochrane Database of Syst Rev. 2007, Issue 4. Art. No.: CD003843. DOI: 10.1002/14651858.CD003843.pub2.

4. Zhang, C. Bispectral index monitoring prevents awareness during total intravenous anesthesia: a prospective, randomized, double-blinded, multi-center controlled trial. Chinese Medical Journal. 2011;124(22):3664-3669.

5. Myles PS, Leslie K, McNeil J, et al. Bispectral index monitoring to prevent awareness during anesthesia: the B-Aware randomised controlled trial. Lancet. 2004;363(9423):1757-1763.

6. Ekman A, Lindholm ML, Lennmarken, Sandin R. Reduction in the incidence of awareness using BIS™ monitoring. Acta Anaesthesiol Scand. 2004:48(1):20-26.

7. Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. N Engl J Med. 2008;13;358(11):1097-1108.

8. Avidan MS, Jacobsohn E, Glick D, et al; BAG-RECALL Research Group. Prevention of intraoperative awareness in a high-risk surgical population. N Engl J Med. 2011;18;365(7):591-600.

9. Mashour GA, Shanks A, Tremper KK, et al. Prevention of intraoperative awareness with explicit recall in an unselected surgical population: A randomized comparative effectiveness trial. Anesthesiology. 2012;117:717-725.

References:

1. Chiu CL, Ong G, Majid AA. Impact of bispectral index monitoring on propofol administration in patients undergoing cardiopulmonary bypass. Anaesthesia Intensive Care. 2007;35:342-347.

2. White PF, Ma H, Tang J, et al. Does the use of electroencephalographic bispectral index or auditory evoked potential index monitoring facilitate recovery after desflurane anesthesia in the ambulatory setting? Anesthesiology. 2004;100(4):811-817.

3. Wong J, Song D, Blanshard H, et al. Titration of isoflurane using BIS™ index improves early recovery of elderly patients undergoing orthopedic surgeries. Can J Anaesth. 2002; 49(1):13-18.

4. Conte V, L’Acqua C, Rotelli S, Stocchetti N. Bispectral index during asleep-awake craniotomies. J Neurosurg Anesthesiol. 2013; 25(3):279-284.

5. National Institute for Health and Clinical Excellence. Depth of anaesthesia monitors (E-Entropy, BIS™ and Narcotrend) (DG6). November 2012. Available at: http://guidance.nice.org.uk/DG6.

References:

1. Gan TJ, Glass PS, Windor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS™ Utility Study Group. Anesthesiology. 1997;87(4):808-815.

2. White PF, Ma H, Tang J, et al. Does the use of electroencephalographic bispectral index or auditory evoked potential index monitoring facilitate recovery after desflurane anesthesia in the ambulatory setting? Anesthesiology. 2004;100(4):811-817.

3. Punjasawadwong Y, Phongchiewboon A, Bunchungmongkol N. Bispectral index for improving anaesthetic delivery and postoperative recovery. Cochrane Database of Syst Rev. 2007, Issue 4. Art. No.: CD003843. DOI: 10.1002/14651858.CD003843.pub2.

References:

1. Zhang, C. Bispectral index monitoring prevents awareness during total intravenous anesthesia: a prospective, randomized, double-blinded, multi-center controlled trial. Chinese Medical Journal. 2011;124(22):3664-3669.

2. Myles PS, Leslie K, McNeil J, et al. Bispectral index monitoring to prevent awareness during anesthesia: the B-Aware randomised controlled trial. Lancet. 2004;363(9423):1757-1763.

3. Ekman A, Lindholm ML, Lennmarken, Sandin R. Reduction in the incidence of awareness using BIS™ monitoring. Acta Anaesthesiol Scand. 2004:48(1):20-26.

4. Sebel PS, Bowdle TA, Ghoneim MM, et al. The incidence of awareness during anesthesia: a multicenter United States study. Anesth Analg. 2004;99(3):833-839.

5. Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. N Engl J Med. 2008;13;358(11):1097-1108.

6. Avidan MS, Jacobsohn E, Glick D, et al; BAG-RECALL Research Group. Prevention of intraoperative awareness in a high-risk surgical population. N Engl J Med. 2011;18;365(7):591-600.

7. Mashour GA, Shanks A, Tremper KK, et al. Prevention of intraoperative awareness with explicit recall in an unselected surgical population: A randomized comparative effectiveness trial. Anesthesiology. 2012;117:717-725.