Anest. intenziv. Med. 2016;27(6):349-357

Depth of anaesthesia monitoringAnaesthesiology - Review articles

J. Divák^1,2,*, M. Frelich^1,2, R. Kula^1,2

¹ Klinika anesteziologie, resuscitace a intenzivní medicíny, FN Ostrava

² Lékařská fakulta, OU v Ostravě, Ostrava

Monitoring in the course of general anaesthesia (GA) may be divided into the monitoring of individual GA components (hypnotic, analgesic and muscle relaxation), and monitoring of the function of organ systems, which also includes monitoring of the depth of GA.
Depth of GA is defined as a decrease of the central nervous system (CNS) activity, and a decrease of the CNS ability to react to external stimuli. Insufficient GA depth is associated with a high risk of perioperative awareness and can lead to serious consequences for the patient, including the post-traumatic stress reaction and serious post-operative psychological consequences. The incidence of perioperative awareness is reported between 0.1 and 0.2%; the condition is associated with a number of risk factors which can be divided into patient factors, surgical procedure factors and risk factors related to the GA management. Recent studies suggest that excessively deep GA may be associated with worsened postoperative prognosis as well.
The aim of the article is to provide the reader with a basic overview of the depth of GA monitoring options. The authors mention recommendations regarding depth of GA monitoring, and recommendations for the management of perioperative awareness.
The review article has been prepared using PubMed/Medline databases, with the following keywords: depth of general anaesthesia, monitor, monitoring and awareness.

Keywords: monitoring the depth of general anaesthesia; depth of general anaesthesia; perioperative awareness; EEG; evoked potentials

Received: April 13, 2016; Accepted: June 5, 2016; Published: December 1, 2016  Show citation