Introduction of bispectral index monitoring in a district general hospital operating suite: a prospective audit of clinical and economic effects.
OBJECTIVE
Randomized controlled trials have shown several beneficial effects of intraoperative bispectral index monitoring. We conducted a prospective audit to determine whether these could be replicated in everyday clinical practice.


METHODS
Recovery characteristics and drug costs from two 4-week periods were compared, immediately before (phase 1, n = 427 patients) and after (phase 2, n = 299 patients) the introduction of bispectral index monitoring in the main operating theatres of a district general hospital.


RESULTS
Demographic and intraoperative variables for the two patient groups were similar. Nausea (P = 0.002), vomiting (P = 0.008) and antiemetic use (P = 0.001) in the postanaesthesia care unit all decreased in phase 2, though unrelated changes in antiemetic policy may have been partly responsible. Recovery time was unaffected. Drug costs decreased in phase 2 by an average of 0.86 pounds per patient. The cost of each semi-reusable sensor was 6.60 pounds.


CONCLUSIONS
In a prospective audit, benefits of intraoperative bispectral index monitoring in our district general hospital were not seen to the same degree as in randomized controlled trials elsewhere.
Satisha
Mallikarjunappa
M
King's College Hospital, London, UK.
Sanders
Graeme M
GM
Badrinath
Manikundalam R
MR
Ringer
Joanna M
JM
Morley
Andrew P
AP
D000328:Adult; D000368:Aged; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods; D018681:Anesthetics, General / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D056805:Consciousness Monitors / Q000191:economics; D016527:Drug Costs; D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000191:economics / Q000379:methods*; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic
D018681:Anesthetics, General