Assessment of Barriers to Using Depth of Anesthesia Monitoring

Background: Depth of Anesthesia monitoring is an available technology used to determine the depth of a patient’s anesthetic by analyzing the electroencephalogram readings of the anesthetized patient. This technology has been available since the 1990s, yet it is not commonly used during the average anesthetic plan. Objective: To determine what barriers prevent anesthesia providers from choosing to use a depth of anesthesia monitor as a regular part of their practice, to assess the needs of the providers involved, and encourage and increase the use of depth of anesthesia monitoring when appropriate. Design: Using descriptive methodology, providers were administered a pretest, self-paced educational module, and posttest that examined their current practice regarding the use of depth of anesthesia monitoring and their willingness to change. Setting: A 487-bed Level I trauma center in Southern Arizona. Participants: Seven Certified Registered Nurse Anesthetists (CRNAs) Measurements: Responses to pretest and posttest questions, and comparisons between the two surveys based on provider. Results: Most providers have never used a depth of anesthesia monitor at this facility, though they would be willing to try using them. Providers had a strong knowledge of when depth of anesthesia monitoring is recommended, but reported they prefer a different approach to monitoring anesthetic depth. Conclusion: Providers reported that an in-service on the monitors would enhance their ability to use the monitors and give them confidence in interpretation of the monitor’s values