Depth of anaesthesia monitoring: time to reject the index?

Timothy J McCulloch; Robert D Sanders

doi:10.1016/j.bja.2023.04.016

Depth of anaesthesia monitoring: time to reject the index?

Br J Anaesth. 2023 Aug;131(2):196-199. doi: 10.1016/j.bja.2023.04.016. Epub 2023 May 15.

Authors

Timothy J McCulloch¹, Robert D Sanders²

Affiliations

¹ Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia. Electronic address: Tim.McCulloch@sydney.edu.au.
² Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.

PMID: 37198033
DOI: 10.1016/j.bja.2023.04.016

Abstract

Depth of anaesthesia monitors can fail to detect consciousness under anaesthesia, primarily because they rely on the frontal EEG, which does not arise from a neural correlate of consciousness. A study published in a previous issue of the British Journal of Anaesthesia showed that indices produced by the different commercial monitors can give highly discordant results when analysing changes in the frontal EEG. Anaesthetists could benefit from routinely assessing the raw EEG and its spectrogram, rather than relying solely on an index produced by a depth of anaesthesia monitor.

Keywords: anaesthesia; awareness; consciousness; depth of anaesthesia index; electroencephalography; monitoring.

Publication types

Editorial
Comment

MeSH terms

Anesthesia*
Consciousness
Consciousness Monitors
Electroencephalography / methods
Humans