Integrating multiple cerebral monitoring modalities (EEG and evoked potentials) may provide better assessment of anaesthetic depth and early warning of cerebral ischaemia than single methods.
Multimodal cerebral monitoring may enhance depth assessment and ischaemia warning; leaves open need for prospective validation.
The administration rate of general anaesthetic drugs is at present guided by clinical experience, and indirect indicators such as haemodynamic parameters. In the presence of muscle relaxants most of the clinical signs of inadequate anaesthesia are lost and accidental awareness may occur. A number of monitoring modalities, primarily based on analysis of the electroencephalogram (EEG), have been proposed for measurement of the anaesthetic depth. Moreover intraoperative cerebral monitoring may also provide the anaesthetist with early warning of cerebral ischaemia, or information on specific neurological pathways. To facilitate this, it is essential to combine analysis of the spontaneous EEG with recording of evoked potentials, to assess both cortical and subcortical activity/events. None of the reviewed methods, however promising, can alone meet all of the requirements for intraoperative monitoring of cerebral function. We suggest that the future direction should be to integrate several modalities in a single device, to provide valuable new information, upon which to base clinical management decisions.
No takes yet. Share an insight, caveat, or question.
Langford et al. (1994) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: