BIS ™ Technology and TIVA:  Achieving the best clinical outcomes in the age of accountable care organizations (ACOs)


Total intravenous anesthesia (TIVA) offers advantages over inhalational anesthetics that may include reduced rates of post-operative nausea and vomiting, smoother emergence, and improved patient satisfaction.  The BIS monitor allows the clinician to minimize drug cost and improve recovery parameters by allowing more precise titration of IV anesthetics such as propofol.  However, the use of BIS technology for TIVA requires a more complete understanding of how processed EEG works. By learning to identify and troubleshoot common clinical issues like EMG artifact and patient movement in the presence of a low BIS number, practitioners can improve both patient outcome and their own confidence in BIS technology. Dr. Marsh will show how TIVA with BIS will help anesthesia clinicians increase value to hospitals, payers, and new healthcare partners like Accountable Care Organizations (ACOs).

Learning objectives:

1. Discuss how to identify and troubleshoot the common sources of EMG (muscle) artifact that can affect the reliability of the BIS index number.

2. Describe the relationship between the BIS index and patient movement to painful stimulus during anesthesia.