Tuesday, May 25, 1999
Patient won't feel a thing
Device checks anesthesia level
BY TIM BONFIELD
The Cincinnati Enquirer
TriHealth has become the first Tristate hospital system to install new monitoring equipment designed to prevent the nightmare of surgical patients: waking up during the operation.
Experts estimate that 0.2 percent of all surgical patients who receive general anesthesia are not rendered fully unconscious. Their level of recall can range from being able to hear operating room conversations to feeling the surgeons at work.
That 0.2 percent rate translates into about 50 patients a year for TriHealth, whose Good Samaritan and Bethesda hospitals perform more than 27,000 surgeries a year using general anesthesia.
“Waking up under the knife is a big fear among patients,” said Dr. Matt Schantz, an anesthesiologist who works mostly at an outpatient surgery center at Bethesda North. “Patients have seen horror stories on TV. And about 50 percent of patients (in surveys) list it as a concern.”
TriHealth has installed 45 “Bispectral Index” monitors from Massachusetts-based Aspect Medical Systems. The gear measures the depth of unconsciousness by tracking brain waves and converting the data to a 0-to-100 scale. Several hundred hospitals nationwide have installed the equipment since March 1998, when it won U.S. Food and Drug Administration approval.
The Health Alliance of Greater Cincinnati, which includes the University, Christ, Jewish, St. Luke and Fort Hamilton hospitals, is considering the monitors, a spokeswoman said.
“I think this will be a big plus for patients,” Dr. Schantz said.
Lacking equipment that can track brain waves, anesthesiologists track patients via heartbeat and breathing rates. As a result, they tend to give more medication than really needed just to make sure patients stay under, Dr. Schantz said.
With the new equipment, medication can be more accurately controlled, which reduces recall incidents and allows patients to wake up faster after surgery. In turn, that means hospitals can save money on anesthesia drugs and may be able to do more surgeries per day.
A study of 225,000 surgeries done with the new monitoring equipment reported that five patients reported some level of recall, Dr. Schantz said. Under the old 0.2 percent rate, about 450 patients would have been expected to have some recall.
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