Neurosurgical patients are at increased risk of complications which increases morbidity and mortality. Early diagnosis helps in the reduction of future insults and facilitates early intervention and decreased postoperative morbidity. In post anaesthesia care unit, GCS and vital signs are monitored for early detection of potential complications.

Extubation of neurosurgical patients is determined by preop condition, intraoperative course, adequacy of hemostasis, blood loss, haemodynamic stability and duration of surgery. Even though GCS is a time-tested tool well validated and used worldwide for neurological assessment, its utility in the immediate postop period is debatable due to anaesthetic residual effects, interobserver variability and lack of continuous monitoring. Depth of anaesthesia monitoring has evolved to a significant extent and anaesthetic administration is totally guided by processed EEG monitors like BIS, sedline and Entropy.

BIS and GCS synchrony have been extensively studied in neurotrauma procedures evaluation of GCS is difficult. 

we propose that BIS a processed EEG monitor could detect changes in consciousness in the postoperative period. and thus aid in the prediction of neurological decline.

In our study, we would like to determine if postoperative BIS monitoring is comparable to standard neurological assessment in predicting complications.