Monitoring of processed EEG under anesthesia II

Česká verzia

Authors: M. Horáček
Authors place of work: Katedra anesteziologie a intenzivní medicíny, Institut postgraduálního vzdělávání ve zdravotnictví, Praha ; Klinika anesteziologie, resuscitace a intenzivní medicíny, 2. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice v Motole, Praha
Published in the journal: Anest. intenziv. Med., 33, 2022, č. 3-4, s. 153-160
Category: Review Article
doi: https://doi.org/10.36290/aim.2022.025

Summary

Processed EEG (pEEG) monitoring is currently used in four indications. The benefit has been demonstrated in the reduction of awakening and recovery times and in reducing the risk of accidental awareness during general anesthesia with the TIVA technique, while the indications for prevention of too deep anesthesia and personalization of anesthesia management are still questionable. Intuitively, it seems that personalized management of anesthesia using data not only from pEEG, but also from other basic monitors could improve results. The relevant studies are still ongoing. Spectrograms obtained by Fourier transformation of the raw EEG curve are suitable for personalizing anesthesia. In the spectrograms, there are significant variations between individual anesthetics, which are caused by different mechanisms of effects and various effects on neuronal circuits in the brain. Parameters such as median frequency and spectral edge frequency (SEF) are also useful. The spectrograms are shown on some monitors that are already commonly available in the Czech Republic such as SedLine Sedation Monitor, Conox or newer generation BIS devices. To titrate antinociception in anesthesia, not only pEEG, but other parameters from basic monitoring, such as respiratory system compliance, the difference between inhaled and exhaled oxygen concentration, Surgical Plethysmography Index from pulse oximetry can also be used. Aging-related EEG changes and the use of spectrograms at the beginning, during maintenance, and emergence from anesthesia will be presented in the third part of this collection of articles.

Keywords:

EEG – Anesthesia – depth of anesthesia index – spectrogram – Fourier transformation

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