The BIS monitor has seen its share of controversies. Opinions on the $20 headband range from: “worthless piece of sheet” to “malpractice to do GA without one”. And of course as with most things, the truth probably lies somewhere in the middle. My practice rarely has them available but if I have a sick-y or an old-y it gives me that extra reassurance that 1/2 MAC is really all they need.
Preventing awareness under anesthesia has been their main marketing tactic. In fact, I wouldn’t be surprised if the corporates funded the awful movie Awake starring Hayden Christensen. The literature however has been less than kind to their claims:
From NEJM as summarized by Medscape:
August 17, 2011 — Unintended intraoperative awareness occurs in more patients receiving general anesthesia with the bispectral index (BIS) protocol vs end-tidal anesthetic-agent concentration (ETAC), according to the results of a prospective, randomized trial reported in the August 18 issue of the New England Journal of Medicine
Guess this means the old way is still the best way? Unless you do a lot of TIVA of course. Hmm.