Skip Navigation

If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".

Electronic Letters to:

Clinical Investigations:
O. Dressler, G. Schneider, G. Stockmanns, and E. F. Kochs
Awareness and the EEG power spectrum: analysis of frequencies
Br. J. Anaesth. 2004; 93: 806-809 [Abstract] [Full text] [PDF]
*E-letters: Submit a response to this article

Electronic letters published:

[Read E-letter] What does this mean to anaesthetic practice?
Rainer J tom Wörden   (20 December 2004)

What does this mean to anaesthetic practice? 20 December 2004
Top
Rainer J tom Wörden,
Anaesthetist

Send letter to journal:
Re: What does this mean to anaesthetic practice?

Dear Sir,

with interest I read the above-mentioned article by Dressler et al. I wonder whether or not the reader's attention is drawn to the significance of their findings for clinical practice.

This I thought after reading what clinical observation exactly was correlated with EEG readings in Dressler's study. The authors claim to detect awareness, however, closely looked at, clinical awareness was only defined as a form of response to verbal command.

In clinical practice of theatre anaesthesia it certainly would be far more informative to find out which interpretations of EEG readings (if any) would ascertain the absence of repsonse, not to verbal command but, to noxious stimuli since no anaesthetist would dare rely on absence of response to verbal command in order to proceed with anaesthetic manipulations on the patient. Why should we infer from the useful analysis of EEG interpretation in the state of unresponsiveness to verbal command to the a clinically relevant analysis of EEG interpretation in the state of unresponsiveness to noxious stimuli? Vanluchene et al (1) found no correlation between several EEG monitoring modes and response to noxious stimuli.

Not only in the light of Vanluchene A L G et al's article (1) in this journal it is unlikely that the findings of Dressler's above-mentioned article will signify a breakthrough in the attempt to invent a technical monitor which provides data on which to rely is safer than clinical observation in anaesthetic practice.

With kindest regards,

Dr R t Wörden, D.E.A.A. Hamburg

1 Vanluchene A L G et at; BJA 93(5):645-54 (2004)

Conflict of Interest:

None declared