Prevention of awareness by using bispectral index monitoring in a patient with history of awareness.

We describe a case in which risk of awareness was minimized by using bispectral index monitoring. The patient had a history of awareness in two previous surgeries. She was a 50-year obese female, known case of hypertension and acid peptic disease, with a history of hysterectomy and cholecystectomy performed 3 years and 2 years ago respectively, and gave a history of awareness in both operations.

Anaesthesia for the elderly patient.

As life expectancy increases, the number of geriatric patients coming for surgery and anaesthesia will make up an increasing portion of our practice. Advancing age, comorbidities, altered pharmacokinetics and dynamics increase the morbidity and mortality of these patients. The importance of doing a thorough preoperative evaluation and identifying risk factors cannot be over emphasized in this frail and vulnerable group.