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Overview

Discover how BIS™ based protocols can help you monitor and tailor anaesthesia for each patient.

Patient-Specific Drug Titration

Transforming Anaesthesia Delivery — One Patient at a Time

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

  • BIS™ monitoring enabled a 50% reduction in propofol administration during hypothermic cardiopulmonary bypass([FOOTNOTE=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. (No funding or sponsorship provided by Medtronic for this study)],[ANCHOR=],[LINK=])
  • End-tidal desflurane concentration was reduced by 25% compared with standard anaesthesia-monitoring practice([FOOTNOTE=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. (No funding or sponsorship provided by Medtronic for this study)],[ANCHOR=],[LINK=])
  • 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 surgery([FOOTNOTE=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. (Supported in part by a grant from Aspect Medical Systems - now Covidien / Medtronic)],[ANCHOR=],[LINK=])
  • For asleep-awake craniotomy procedures, where titratable anaesthesia is preferred to facilitate more predictable intraoperative wake-up, BIS™ monitoring can provide further information to guide drug administration and predict responsiveness.([FOOTNOTE= Conte V, L’Acqua C, Rotelli S, Stocchetti N. Bispectral index during asleep-awake craniotomies. J Neurosurg Anesthesiol. 2013; 25(3):279-284. (No funding or sponsorship provided by Medtronic for this study)],[ANCHOR=],[LINK=])

Improved Emergence, Recovery, and Discharge

BIS™ Monitoring Outcomes

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

  • Faster extubation.1,3
  • Faster emergence.1
  • Better orientation at the post-anaesthesia care unit (PACU).1
  • Faster discharge.1,3

Reduced Incidence of Awareness

BIS™ Monitoring

Studies show an 80% reduction in awareness has been demonstrated when using BIS™ monitoring compared to routine care in both intravenous (TIVA, total intravenous anaesthesia) and inhaled drug combinations in anaesthesia patients.([FOOTNOTE= 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. (No funding or sponsorship provided by Medtronic for this study)],[ANCHOR=],[LINK=]),([FOOTNOTE= 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. (Some unrestricted funding for this study was provided by Aspect Medical Systems (Newton, MA, USA). )],[ANCHOR=],[LINK=]),([FOOTNOTE=Ekman A, Lindholm ML, Lennmarken, Sandin R. Reduction in the incidence of awareness using BIS™ monitoring. Acta Anaesthesiol Scand. 2004:48(1):20-26. (This study was supported by a grant from Aspect Medical Systems, MA - now Covidien / Medtronic)],[ANCHOR=],[LINK=])

With TIVA procedures, the incidence of awareness can be 5-10 times greater than with inhaled anaesthetics as a result of the short-acting nature of some intravenous anaesthetics 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 anaesthesia.([FOOTNOTE= 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. (Supported by a grant from Aspect Medical Systems - now Covidien / Medtronic)],[ANCHOR=],[LINK=])

Clinical Evidence

Intraoperative Awareness Prevention

"The prospective studies incorporating BIS™-based protocols provide proof of principle that a brain monitor can be effective in decreasing the incidence of AWR."([FOOTNOTE= 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. (No funding or sponsorship provided by Medtronic for this study)],[ANCHOR=],[LINK=])

– Author George Mashour, et al., in a clinical review on the prevention of intraoperative awareness with explicit recall.

Improving 
anaesthetic Delivery and Postoperative Recovery

"Anesthesia guided by BIS™ could improve anesthetic delivery and postoperative recovery from relatively deep anesthesia."([FOOTNOTE=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. (No funding or sponsorship provided by Medtronic for this study)],[ANCHOR=],[LINK=])

– Authors Yodying Punjasawadwong, Aram Phongchiewboon, and Nutchanart Bunchungmongkol, in a clinical review of bispectral index for improving anaesthetic delivery and postoperative recovery.

NICE Guidelines Recommend BIS™ Monitoring

"BIS™ monitoring is recommended as an option for all patients receiving total intravenous anesthetic (TIVA). BIS™ technology is also cost effective in this patient population due to the inability to measure end-tidal anesthetic concentration."([FOOTNOTE=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. (Sponsorship provided by Covidien - now Medtronic - amongst others - for this study)],[ANCHOR=],[LINK=])

– National Institute for Health and Clinical Excellence

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