Please select the eligibility criteria that correspond to the clinical trial below.
Title: B-Unaware Study: Comparison of BIS-guided Anesthesia With End-Tidal Volatile-Guided Anesthesia to Decrease The Incidence of Awareness During High-Risk Surgery
Brief Summary: The overall purpose of this study is to see if a Bispectral Index (BIS) monitor, a Food and Drug Administration (FDA) approved brain monitoring device, will help to reduce the risk of patients remembering being awake during surgery. The BIS monitor may be able measure how asleep a patient is during surgery. Using the BIS monitor to guide anesthesia will be compared with using the concentration of anesthetic gas to guide anesthesia.


Options:
A: Inclusion criteria:

1. elderly patients (age range 60-90 years);
2. scheduled to undergo noncardiac thoracic or abdominal surgery with an expected duration of 2 hours or longer. For those who undergo thoracoscopic or laparoscopic surgery, the expected length of incision must be 5 centimeters or more;
3. agree to receive patient-controlled postoperative analgesia.

Exclusion criteria (patients who meet any of the following criteria will be excluded):

1. previous history of schizophrenia, epilepsy or Parkinson disease, or unable to complete preoperative assessment due to severe dementia, language barrier or end-stage disease;
2. history of myocardial infarction within 3 months before surgery;
3. any contraindication to epidural anesthesia and analgesia, including abnormal vertebral anatomy, previous spinal trauma or surgery, severe chronic back pain, coagulation disorder (prothrombin time or activated partial prothrombin time longer than 1.5 times of the upper limit of normal, or platelet count of less than 80 × 10\^9/L), local infection near the site of puncture, and severe sepsis;
4. severe heart dysfunction (New York Heart Association functional classification 3 or above), hepatic insufficiency (Child-Pugh grades C), or renal insufficiency (serum creatinine of 442 μmol/L or above, with or without serum potassium of 6.5 mmol/L or above, or requirement of renal replacement therapy); or
5. any other conditions that were considered unsuitable for study participation.
B: Inclusion Criteria:

* American Society of Anesthesiologists (ASA) Class 1 or 2 or 3
* Scheduled to undergo an elective abdominal surgical procedure under general anesthesia; and:

  * expected to undergo neuromuscular relaxation with rocuronium for

endotracheal intubation; and

* expected to require at least one maintenance dose of rocuronium; and
* expected to require active reversal of neuromuscular blockade; and
* expected to require clinical or subjective neuromuscular monitoring only; and
* expected to recover in the PACU

  * Arm that is accessible for measuring the TOF ratio in the PACU
  * Sexually active female patient of child-bearing potential must agree to use a

medically accepted method of contraception through seven days after receiving

protocol-specified medication.

Exclusion Criteria:

* Anatomical malformations that may lead to difficult intubation
* Neuromuscular disorder(s) that may affect neuromuscular blockade and/or trial assessments
* Dialysis-dependent or has or is suspected of having severe renal insufficiency
* Significant hepatic dysfunction
* Family history of malignant hyperthermia
* Cardiac pacemaker
* Allergy to study treatments or its/their excipients, to opioids / opiates, sugammadex, muscle relaxants or their excipients, or other medication(s) used during general anesthesia
* Toremifene before or within 24 hours of study drug administration
* Scheduled for an overnight stay (or \>12 hours) in PACU
* Expected transfer to an Intensive Care Unit after surgery
* Pregnant, intention to become pregnant between randomization and the Day 30 pregnancy follow-up visit
* Breast-feeding.
* Investigational drug(s) within 30 days of randomization on this study
* Participation in any other clinical trial within 30 days, inclusive, of signing the informed consent form of the current trial
* Participant or family member is among the personnel of the investigational or Sponsor staff directly involved with this trial
C: Inclusion Criteria:

MUST HAVE:

General Anesthesia with volatile anesthetic

PATIENT CHARACTERISTICS

Major Criteria (any 1 of the following:)

1. Medications - anticonvulsants, abuse of opiates, benzodiazepines, cocaine
2. EF\<40%
3. Prior history of awareness (recall)
4. History of difficult intubation or anticipated difficult intubation
5. ASA IV or V status
6. Aortic stenosis
7. End stage lung disease
8. Marginal exercise tolerance not secondary to musculoskeletal dysfunction
9. Pulmonary hypertension
10. Daily alcohol consumption

Minor Criteria (any 2 of the following)

1. Beta blockers
2. COPD
3. Moderate exercise tolerance not secondary to musculoskeletal dysfunction
4. Smokes ≥2 packs per day
5. Morbid obesity BMI\>30 -

Exclusion Criteria:

1. Surgical procedure that prevents the use of the BIS (e.g surgery of forehead)
2. Patient positioning prevents use of the BIS
3. Surgery with wake-up test.
4. Less than 18 years of age
5. Vulnerable populations, such as those with dementia and those unable to provide informed consent.
6. Stroke with residual neurological deficits
D: Inclusion Criteria:

* High risk for delirium age \> 65 history of delirium medical comorbidities ability to give informed consent

Exclusion Criteria:

* Dementia Alcohol abuse Current use of an antipsychotic Allergy to olanzapine

Answer: C