Magazine article Drug Topics

New Device Aims to Ensure Proper Anesthetic Dosing

Magazine article Drug Topics

New Device Aims to Ensure Proper Anesthetic Dosing

Article excerpt

The issue of medical mistakes has become so paramount that the government has made a federal case of it, pushing for a 50% reduction in errors over the next five years.

The human cost of medical errors is high. According to a report issued by the Institute of Medicine (IOM), more people die from medical mistakes each year than from highway accidents, breast cancer, or AIDS. The same report, however, cites anesthesia-one of the most perilous specialties of medicine-as one of the safest. Since the early 1980s, injuries and deaths occurring among the 20 million patients who undergo surgery with general anesthesia each year have dropped from one in 10,000 to one in 250,000. This decrease is mainly the result of new procedures, drugs, and technologies.

The latest technology in anesthesia is the Bispectral Index (BIS). BIS technology, from Aspect Medical Systems, Newton, Mass., is the only technology on the market that directly measures a patient's level of consciousness under anesthesia during surgery or critical care procedures, the company claims. This allows anesthesiologists and clinical pharmacists to administer the precise amount of drug required for each patient, resulting in improved outcomes and reduced hospital costs.

Every patient is unique and requires customized anesthesia to achieve an adequate level of hypnosis. In the past, anesthesiologists had to rely on standard dosages and the patient's vital signs to ensure the patient was receiving an adequate amount of sedation. The problem is that vital signs do not directly measure the consciousness level, plus standard dosages are based on the needs of an .average, middle-aged male, which :may be inadequate for other demographic groups. When a person receives more sedation than necessary, the result is "anesthesia hangover"-a prolonged, often nauseous, recovery. When patients receive a dose that's less than required, there is a chance of awareness during surgery. As many as 170,000 patients area estimated to experience awareness (and the resultant fear, panic, and pain) each year.

BIS is designed to solve this dilemma by providing a consciousness mea surement based on electroen-- cephalogram (EEG), a wave form representing the electrical activity of the brain. The EEG signals are captured using a sensor strip placed on tree patient's forehead. Using the BIS index of 0 (an absence of brain activity) to 100 (fully awake), doctors can easily and rapidly determine level of consciousness. …

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