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Clinical Electroencephalography for Anesthesiologists

Author(s)
Purdon, Patrick L.; Sampson, Aaron; Pavone, Kara J.; Brown, Emery Neal
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Abstract
The widely used electroencephalogram-based indices for depth-of-Anesthesia monitoring assume that the same index value defines the same level of unconsciousness for all anesthetics. In contrast, we show that different anesthetics act at different molecular targets and neural circuits to produce distinct brain states that are readily visible in the electroencephalogram. We present a two-part review to educate anesthesiologists on use of the unprocessed electroencephalogram and its spectrogram to track the brain states of patients receiving anesthesia care. Here in part I, we review the biophysics of the electroencephalogram and the neurophysiology of the electroencephalogram signatures of three intravenous anesthetics: propofol, dexmedetomidine, and ketamine, and four inhaled anesthetics: sevoflurane, isoflurane, desflurane, and nitrous oxide. Later in part II, we discuss patient management using these electroencephalogram signatures. Use of these electroencephalogram signatures suggests a neurophysiologically based paradigm for brain state monitoring of patients receiving anesthesia care.
Date issued
2015-10
URI
http://hdl.handle.net/1721.1/112106
Department
Institute for Medical Engineering and Science; Harvard University--MIT Division of Health Sciences and Technology; Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences
Journal
Anesthesiology
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Citation
Purdon, Patrick L. et al. “Clinical Electroencephalography for Anesthesiologists.” Anesthesiology 123, 4 (October 2015): 937–960 © 2015 the American Society of Anesthesiologists, Inc
Version: Author's final manuscript
ISSN
0003-3022

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