Adequacy of Anesthesia

Dear Clinician,
The new topic of the Clinical Window Web Journal (CWWJ) is the adequacy of anesthesia, and we have focused particularily on the monitoring of hypnosis with the bispectral index (BIS).

First, Dr. Michel Struys (Ghent University Hospital) introduces the modern anesthesia concept. Evolution started from the classic theory which was based on the unitary non-specific mechanisms of anesthetic actions. This was questioned in the 1950's and 1960's, when neuromuscular blocking agents, opioids, and barbiturates were increasingly used in combination with inhaled anesthetics. Explaining the developing theories, he then guides us to current scientific knowledge. In his review of the modern hypothesis of general anesthesia, he includes topics like depth of anesthesia, nociception, and perception of pain.

Building on the modern concept of general anesthesia, Dr. Yli-Hankala (Tampere University Hospital) continues by discussing the clinical value of hypnosis monitoring. First assessing the impact of processed EEG, he then continues by reviewing the utility of the BIS in monitoring of hypnosis. His summary: "hypnosis monitoring facilitates a clinician’s better understanding of the concept of modern anesthesia. That concept is based on a group of parallel effects; ideally, each of them should be monitored by special techniques" nicely concludes what this issue of CWWJ is all about.

Many thanks to our authors for their great contributions. In addition, thanks to the readers I had the pleasure to meet at the ESICM congress in Geneva. Great talking to you.

Ilkka S. Kalli MD, PhD, MBA
Anesthesiologist, Editor-in-Chief
Datex-Ohmeda’s Clinical Window Web Journal

Last updated: 1 November 2001Created
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