Novel Incorportation Of Biomedical Engineering Algorithms (bispectral Index Guided Or Anesthetic Concentration Guided) In Real-Time Decision Support To Prevent Intraoperative Awareness Using An Electronic Anesthesia Information Mananagement System

NOVEL INCORPORATION OF BIOMEDICAL ENGINEERINGALGORITHMS (BISPECTRAL INDEX GUIDED OR ANESTHETICCONCENTRATION GUIDED) IN REAL-TIME DECISION SUPPORT TOPREVENT INTRAOPERATIVE AWARENESS USING AN ELECTRONICANESTHESIA INFORMATION MANAGEMENT SYSTEMbyAMY MELANIE SHANKSMay 2015 Advisors: Drs. John M. Cavanaugh and George A. Mashour Major: Biomedical Engineering Degree: Doctor of Philosophy Background: Intraoperative awareness with explicit recall (AWR) is a fearedcomplication of surgery that can lead to significant psychological distress. Several largeprospective trials have been completed comparing two methods of monitoring anesthetic depth[minimum alveolar concentration (MAC) or electroencephalography (EEG) monitoring using thebispectral index (BIS)] for the prevention of AWR. However, these trials were conducted inhigh risk populations, limiting generalizability. Research Hypothesis: Real-time decision support with Anesthesia InformationManagement System alerts based on a novel anesthetic concentration algorithm (incorporatingthe use of intravenous anesthetics) or an EEG-guided algorithm will reduce the known incidenceof AWR.