The method of automated adjustment and controlled maintenance of surgical stage of anesthesia in modern anesthesia machines

The method of automatical adjustment controlled maintenance of the surgical stage of anesthesia of patient during general anesthesia by means of volatile anesthetic dosage regulation depending on BIS level is described and explained. There was conducted a theoretical analysis of possibilities and perspectives of anesthesia depth’s automatical adjustment during general anesthesia by bispectral index individual monitoring depending on volatile anesthetic dosage and individual patient’s condition along with extent of surgical intervention. The possibilities of currently available medical devices allowing to implement the method into the practice have been analyzed. The technical explanation of interaction between modern volatile anesthetic vaporizer and bispectral index monitoring by feedback from integrated microprocessor, breathing circuit and multiple gas monitor of anesthesia machine and microprocessor of vaporizer has been presented.

Intraoperative hypotension and perioperative outcomes

Intraoperative hypotension is associated with adverse outcomes. Although a causal relationship is yet to be fully established, proactive management of vulnerable patients and use of bispectral index monitoring is recommended to avoid deep anaesthesia.

Awareness and bispectral index (BIS) monitoring in mechanically ventilated patients in the emergency department and intensive care unit: a systematic review protocol

IntroductionAccidental awareness with recall is one of the most feared complications for patients undergoing general anaesthesia and can lead to post-traumatic stress disorder in up to 70% of patients experiencing it. To reduce the incidence of awareness with recall, the bispectral index monitor is recommended for patients receiving total intravenous anaesthetics, especially those receiving neuromuscular blockers. While extensive investigation into awareness and bispectral index monitoring has occurred for operating room patients, this has not extended to other clinical arenas where sedated and mechanically ventilated patients are cared for, namely the intensive care unit and emergency department. The purpose of this systematic review is to assess the world’s literature to determine the incidence of awareness with paralysis in mechanically ventilated patients and the impact of bispectral index monitoring for reducing this complication.Methods and analysisRandomised trials and non-randomised studies are eligible for inclusion. With aid from a medical librarian, an electronic search will include Ovid Medline, Embase.com, Scopus, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials. To find data published in abstract form, literature from professional society conferences (2010–2019) will be manually searched. Two authors will independently review search results and consensus will be reached with assistance from a third author, as needed. Heterogeneity and publication bias will be assessed and reported. If possible and appropriate, a meta-analysis of the data will be conducted for quantitative data analysis.Ethics and disseminationThe proposed systematic review does not require ethical approval, as it is conducted at the study level and does not involve individual patient-level data. Results will be disseminated by data sharing via academically established means, presentation at local and national scientific meetings and publication as a peer-reviewed manuscript.PROSPERO registration numberThe protocol has been submitted to International Prospective Register of Systematic Reviews and is awaiting registration.