Key result
Processed electroencephalography monitoring provides data on anesthesia depth, but evidence remains inconclusive regarding its routine use to improve outcomes like delirium, awareness, and mortality.
Why the study?
It remains controversial whether processed electroencephalography monitors can become the gold standard for anesthesia monitoring, and whether p-EEG-guided anesthesia affects perioperative outcomes.
Does processed electroencephalography (p-EEG) guided anesthesia improve perioperative outcomes in patients undergoing general anesthesia?
Does processed electroencephalography (p-EEG) guided anesthesia improve perioperative outcomes in patients undergoing general anesthesia?
Evidence for p-EEG-guided anesthesia improving perioperative outcomes remains inconclusive, emphasizing the importance of anesthesiologists' skills in interpreting raw EEG data beyond processed indices.
p-EEG-guided anesthesia has uncertain perioperative impact; leaves open need for RCTs before any practice change.
There is a growing interest in monitoring the processed electroencephalography (p-EEG) as a measure of the delivery of anesthetic agent and the depth of the general anesthesia (GA). Each p-EEG monitor constructs an index that is suitable for GA. Although these monitors have become widely used, but it remains controversial whether they can become the gold standard for anesthesia monitoring like pulse oximeter and electrocardiogram. Whether p-EEG-guided anesthesia can affect perioperative outcomes remains unclear. This narrative review describes the relationship between p-EEG monitoring and perioperative outcome such as postoperative neurocognitive function, intraoperative awareness and mortality. Also, this article describes how and what to look beyond the index of processed electroencephalographic monitors. Abbreviations: GA: General anesthesia; EEG: Electroencephalogram; BIS: Bispectral index; POD: Postoperative delirium; CODA: Cognitive Dysfunction after Anaesthesia; POCD: Postoperative cognitive dysfunction; PACU: Post-anesthetic care unit; POQI-6: Perioperative Quality Initiative-6 Consensus Key words: Anesthesia; Delirium; Electroencephalography; Intraoperative awareness; Mortality Citation: Lee KH. Beyond the index of processed electroencephalography: a narrative review. Anaesth. pain intensive care 2022;27(1):112−118; DOI: 10.35975/apic.v27i1.2128 Received: April 07, 2022; Reviewed: August 16, 2022; Accepted: October 20, 2022
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Ki Hwa Lee (2023) conducted a review in General anesthesia. Processed electroencephalography (p-EEG) monitoring vs. Routine care or end-tidal anesthetic concentration (ETAC) monitoring was evaluated. Processed electroencephalography monitoring provides data on anesthesia depth, but evidence remains inconclusive regarding its routine use to improve outcomes like delirium, awareness, and mortality.
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