Electroencephalography: Clinical Applications During the Perioperative Period

Abstract

Electroencephalography (EEG) monitoring has become technically feasible in daily clinical anesthesia practice. EEG is a sensitive method for detecting neurophysiological changes in the brain and represents an important frontier in the monitoring and treatment of patients in the perioperative period. In this review, we briefly introduce the essential principles of EEG. We review EEG application during anesthesia practice in the operating room, including the use of processed EEG in depth of anesthesia assessment, raw EEG monitoring in recognizing brain states under different anesthetic agents, the use of EEG in the prevention of perioperative neurocognitive disorders and detection of cerebral ischemia. We then discuss EEG utilization in the intensive care units, including the use of EEG in sedative level titration and prognostication of clinical outcomes. Existing literature provides insight into both the advances and challenges of the clinical applications of EEG. Future study is clearly needed to elucidate the precise EEG features that can reliably optimize perioperative care for individual patients.

Incidence change of postoperative delirium after implementation of processed electroencephalography monitoring during surgery: a retrospective evaluation study

“…Despite well educated, clinicians reserve the flexibility of making decision according to clinical scenarios; that is, it might require some time for practitioners to recognize pEEG as a reliable tool and involve the monitor in the clinical decision-making process. Essentially, more than the pEEG results in interpreting the results and subsequent prompt management provide benefits to the patients [ 40 ].…”

Basic Electroencephalogram and Its Common Clinical Applications in Children

“…In most people eye closure will result in frequency transfer from beta to alpha rhythms. Subsequent wave frequencies were identified the theta rhythm (4-7 Hz) and the delta rhythm (0.5-3 Hz) which are predominant during sleep in adults, and the gamma rhythm (> 30 Hz) which is associated with memory, information processing and cognitive skill (Figure 4) [39]. EEG tracing showing bilateral, diffuse, high amplitude slow waves seen in hypsarrhythmia [47].…”

Intraoperative electroencephalogram patterns as predictors of postoperative delirium in older patients: a systematic review and meta-analysis

“…Given the organic underpinnings of postoperative delirium, monitoring brain activity through electroencephalography (EEG) during surgery emerges as a valuable approach for predicting this complication (Sun et al, 2020 ). Consequently, recent European guidelines on postoperative delirium management advocate for intraoperative monitoring of anesthesia depth and EEG patterns, specifically the burst suppression pattern, despite the limited quality of evidence supporting this recommendation (Aldecoa et al, 2023 ).…”