Anaes Cases · Depth of anaesthesia & awareness
The high-risk awareness patient — the TIVA cardiac surgery
The long case — the cardiac surgery awareness risk (the light anaesthesia on the bypass, the high-stimulus). The depth strategy: the adequate induction, the volatile-to-the-TIVA-on-the-bypass, the pEEG (the BIS) target 40-60, the vigilance, the avoidance of the relaxant-without-the-hypnotic, and the awareness check at the emergence.
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Prompt
A patient for the cardiac surgery on the cardiopulmonary bypass, the high awareness risk. Discuss the depth-of-anaesthesia strategy.
Presentation
A 68-year-old man for the elective coronary artery bypass on the cardiopulmonary bypass. He is anxious and asks "will I be aware during the surgery?" Discuss the depth-of-anaesthesia strategy and the counselling.
References2ShowHide
- [1]Yu H, et al. Depth of anesthesia monitoring: current evidence. J Int Med Res, 2026.PMID 42333677
- [4]Graham M, et al. Minimizing the Harm of Accidental Awareness Under General Anesthesia: New Perspectives From Patients Misdiagnosed as Being in a Vegetative State. Anesth Analg, 2018.PMID 28922237