Electroencephalogram Monitoring in Anesthesia Practice

Abstract: Purpose of Review: We review the basic neurophysiological foundations of the adult electroencephalographic signal and how to apply the EEG to the modern anesthetic clinical practice, the different anesthetic drugs signatures, and their neurobiological background. We finally discuss how the intraoperative use of the EEG may be implemented eventually to improve short- and long-term outcomes. Recent Findings: With the growing knowledge of the electroencephalographic signatures of anesthetic drugs, perioperative EEG monitoring constitutes an important tool to titrate the dose of hypnotic drugs avoiding over- and underdosing and respective adverse effects. During emergence from general anesthesia, the different electroencephalographic trajectories may predict cognitive complications. Educational programs are essential to improve the knowledge of clinicians about how to understand the raw EGG and its spectral analysis. Summary: EEG has become an important tool to manage patients intraoperatively. Major benefits are the optimization of drug dosing and the detection and prediction of neurological complications. There are recent initiatives from various organizations providing EEG education, allowing more clinicians to use the EEG during anesthesia and sedation.