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Monitoring awareness during anaesthesia – a multi-modal approach (ANAEWARE)
Start date: Aug 11, 2014, End date: Aug 10, 2016 PROJECT  FINISHED 

Modern anesthesia is achieved through the administration of a 'chemical cocktail' of agents, each targeting a specific desirable effect (loss of awareness, analgesia, amnesia and immobility). Given that there are no strict dosages for these combinations of agents, the anesthetist follows a set of approximate dosage guidelines and adjusts these based on patient characteristics and past experience. However, administering an incorrect dosage could have serious complications: over-administration of anesthetics could result in cardiovascular depression, while under-administration in intraoperative awareness. The latter in particular could result to severe psychological consequences for the patient and economic consequences in the form of large insurance claims. Given that an estimated 234.2 million major surgical procedures are conducted annually worldwide, the seemingly small reported incidence of awareness (0.1-0.8%) corresponds to approximately 1,873,600 people. Despite the existence of commercially available devices that monitor anesthetic depth through the patient’s electrical brain activity (EEG), reliability and robustness issues stop them from becoming part of routine surgical practice. The project proposes a new direction in the field: the combination of various multi-modal signals to obtain a holistic view of anesthetic-induced changes. How is the body as a whole affected by this chemical 'cocktail'? What are the measurable effects of anesthesia on the relationships between different signals? The project will investigate such questions through the collection and study of multi-modal signals during surgery, and their applicability for wakefulness/anesthesia discrimination. Training in various research and complementary skills will be achieved through the multi-disciplinary nature of the project. Integration of the fellow in an environment with an impressive track record in cutting-edge biomedical research will provide structured long-term career development.
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