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[Intraoperative Neuromonitoring: Electroencephalography].

Victoria Windmann, Susanne Koch

    Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
    |November 25, 2021
    PubMed
    Summary
    This summary is machine-generated.

    Electroencephalography (EEG) monitoring helps anesthesiologists assess anesthesia depth, aiming to prevent intraoperative awareness and postoperative cognitive issues. Understanding EEG patterns improves patient outcomes and operating room efficiency.

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    Area of Science:

    • Anesthesiology
    • Neuroscience
    • Medical Technology

    Background:

    • Intraoperative neuromonitoring with electroencephalography (EEG) is crucial for managing anesthesia depth.
    • It aims to mitigate risks like intraoperative wakefulness, postoperative delirium, and cognitive deficits.

    Purpose of the Study:

    • To elucidate the interpretation of raw EEG, spectrograms, and processed indices across various age groups and anesthetics.
    • To summarize the clinical benefits of EEG-based neuromonitoring.

    Main Methods:

    • Analysis of EEG signatures (α-, δ-, γ-waves) associated with different anesthetics (propofol, volatile anesthetics, ketamine).
    • Evaluation of age-specific EEG characteristics in infants and children, including the onset of frontal α-waves and epileptiform discharges.
    • Assessment of age-related changes in adults, such as decreased frontal α-power and increased burst suppression patterns.

    Main Results:

    • Propofol and volatile anesthetics show distinct frontal EEG patterns, while ketamine can lead to misleadingly high processed indices (BIS, PSI, NI).
    • Valid EEG indices in children are available from approximately 12 months of age; epileptiform discharges are noted in younger children.
    • Older adults exhibit reduced frontal α-power and a higher incidence of burst suppression during anesthesia.

    Conclusions:

    • EEG-based neuromonitoring offers clinical benefits including reduced anesthetic dosage, faster emergence, and decreased intraoperative awareness.
    • Anesthesia guided by processed EEG indices can lower the incidence of postoperative delirium and cognitive deficits in elderly patients.
    • Deeper understanding of intraoperative EEG changes beyond processed indices promises further reduction in perioperative complications.