Thoughts on BIS monitor.

In my (limited) experience I have noticed that providers fall into one of two schools of thought: they are either very much in favor of a BIS monitor, or find the whole thing to be voodoo nonsense.

I don't have a lot of experience with the device, but so far I am not convinced that it provides a reliable measure of whether or not a patient is conscious or at risk of being aware. Especially when one considers this 2015 study.

In summary: 10 volunteers were given neuromuscular blocker with no sedation. A tourniquet was placed on the forearm prior to administration and the volunteers were able to communicate via hand signals. Many of he BIS values reflected sedation (60-80) and some of the values indicated the patient was at a proper level for surgery (40-60). All this despite receiving zero hypnotics, only neuromuscular blocker.

A study like this casts doubt upon my future use of a BIS, but it is also just ONE study, and I am but a simple student. I was hoping to hear your thoughts and practice experience regarding the BIS monitor.