Monitoring the anaesthetic depth in children - an update

Area of Science:

• Anesthesiology
• Neuroscience
• Pediatric Critical Care

Background:

• Electroencephalogram (EEG)-derived devices offer potential for monitoring anesthesia depth.
• Several commercial devices are available, utilizing EEG signals to assess the level of anesthesia.

Purpose of the Study:

• To review published studies on the use of EEG-derived devices for monitoring anesthesia depth in children.
• To assess device performance in observational and physiological studies and review outcome studies.
• To discuss the clinical utility, potential physiological issues, and methodological considerations.

Main Methods:

• Systematic review of published literature on EEG-derived anesthesia depth monitoring in pediatric populations.
• Analysis of physiological studies evaluating device performance against anesthetic agent doses.
• Examination of outcome studies assessing clinical impact, such as drug consumption and recovery time.

Main Results:

• Physiological studies indicate that bispectral index, entropy, Narcotrend index, cerebral state index, and A-line ARX index correlate with anesthetic agents in older children.
• Device performance is significantly reduced in infants.
• Some devices have shown potential to decrease anesthetic drug use and accelerate recovery in older children.

Conclusions:

• The bispectral index is the most studied, but no EEG-derived device demonstrates clear superiority.
• Emerging evidence supports the use of these devices in older children.
• Current evidence does not support the use of EEG-derived anesthesia depth monitoring in infants.