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Are you Aware of Awareness?

This article examines some of the evidence to identify the incidence of awareness with explicit recall following general anaesthesia and whether this incidence is reduced through monitoring of the bispectral index (BIS). It can be concluded from the results of these studies that the use of a protocol to guide anaesthesia delivery can help to reduce the incidence of awareness with explicit recall. However, whether this protocol should be guided by end tidal anaesthetic agent, BIS or some other form of processed electroencephalogram (EEG) cannot be concluded upon until the results of further well designed randomised controlled studies are known.