ArticleAnnals of neurosciences2026
BIS Versus End-tidal Anaesthetic Gas Concentration-guided General Anaesthesia for Prevention of Intraoperative Awareness in Elective Surgery: A Randomised Controlled Trial.
Article in Annals of neurosciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Awareness during general anaesthesia (GA) is a rare but serious complication, affecting 0.15%-0.2% of patients, with potential psychological consequences such as post-traumatic stress disorder (PTSD). Bispectral index (BIS) monitoring, which uses electroencephalography (EEG)-derived metrics to assess anaesthesia depth, has shown promise in reducing intraoperative awareness, though its universal adoption remains limited due to mixed evidence. Purpose: This study aimed to compare BIS-guided and end-tidal anaesthetic gas concentration (ETAG)-guided techniques in a randomised controlled trial conducted in India, addressing gaps in existing literature, particularly among Asian populations. Methods: A total of 674 patients, aged 18-65 years, undergoing elective surgeries were randomised into two groups: BIS ( Results: Awareness incidence was 0.58% in the BIS group and 0.90% in the ETAG group ( Conclusion: This randomised trial found that neither BIS nor minimum alveolar concentration (MAC) demonstrated superiority in terms of intraoperative awareness. Future research should focus on high-risk populations, explore stringent BIS targets (e.g., BIS <50) and explore the cost-effectiveness of these monitoring techniques in various clinical settings.
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