Anesthesia awareness is not lethal but anesthesia over medication, the natural consequence of failing to monitor depth of anesthesia, IS, specifically to the tune of one American patient every day!
Li G, et al: Epidemiology of Anesthesia-related Mortality in the United States, 1999–2005. Anesthesiology 2009;110:759
By trending EMG as a secondary trace, one creates a real time BIS monitor. Responding to spikes in EMG activity as if they were HR or BP changes is the key.
Mathews DM, Clark L, Johansen J, et al. Increases in Electroencephalogram and Electromyogram Variability Are Associated with Increased Incidence of Intraoperative Somatic Response. Anes Analg 2012;114:759-770.
Universal BIS/EMG monitoring would reduce anesthesia drug usage by 30% – a big hit to anesthesia drug makers who, in turn, provide millions of various forms of support dollars to organized anesthesia.
Friedberg BL, Sigl JC: Clonidine premedication decreases propofol consumption during bispectral (BIS) index monitored propofol-ketamine technique for office based surgery. Dermatol Surg 2000;26:848-852.
Every ‘anesthesia awareness’ article is a political statement by organized anesthesia:
“We are for patient safety…
ONLY as long as it doesn’t screw with the drug company money.”
Stop drinking the Kool Aid & stop the epidemic of anesthesia over medication…
Disclaimer: Neither I, nor my non-profit Goldilocks Anesthesia Foundation, receive financial support from brain monitor or drug makers.