Review: EEG-guided anesthesia in patients with Neurological Disorders
Poster #: 032
Session/Time: A
Author:
Bharadwaj Chintalapati, BA
Mentor:
Alberto E. Musto, MD, PhD
Research Type: Review Article
Abstract
INTRODUCTION:
Successful anesthesia administration relies on various real-time monitoring, such as heart rate and respiratory rate, to adjust treatment for how a patient may respond to a specific anesthetic medication. This insight into the physiological state of the patient allows for more informed anesthesia administration. EEG utilization potentially provides another line of insight into the state of a patient under anesthesia, by giving real-time insight into the electrical activity of a patient's brain. EEG-guided anesthesia has been implemented variably in the past in populations that may be at higher risk or have more stringent anesthetic needs, such as children, but the use of EEG during anesthesia administration is currently unstandardized. It can be a valuable asset in providing individualized dosages and treatment regimens by providing another stream of data, and anesthesiologists can monitor for reactivity to administered anesthetics. In this review, we are examining how EEG has been applied in patients with specific neurological conditions, such as TBIs or Alzheimer's disease, with a goal of identifying its role as real-time monitoring method in this higher-risk population.
MAIN BODY:
This scoping review project aims to examine EEG-guided anesthesia in patients with pre-existing neurological conditions with the aim of identifying its potential to improve perioperative outcomes. We conducted a search using multiple databases on topics relating to anesthetic complications, EEG-guided anesthesia, or patients with select neurological disorders. A preliminary review on relevant literature suggests that EEG-guided anesthesia could benefit patients with certain neurological conditions that have a higher likelihood of anesthetic complications than the general population, such as increased postoperative confusion and delirium. In healthy patients, general anesthesia affects the EEG by causing dose-dependent slowing of rhythms, with higher dosing showing burst suppression patterns, which can be used as markers to guide dosing. Neurological disorders can impact baseline EEG readings, such as having a lower alpha/theta ratio in patients with Alzheimer's Disease compared to healthy patients at rest.
CONCLUSION:
EEG-guided anesthesia may provide benefits in accurate dosing of anesthetics to minimize the risk of over-sedation or under-sedation and their associated complications, but disease-specific considerations are necessary to be able to practically improve outcomes in patients who present with altered baseline EEG readings. As part of our continued approach, a systematic search using multiple databases, including PubMed, will be done and articles will be included and excluded based on relevance. Articles will be synthesized to map the current state of EEG-guided anesthesia integration and benefit for patients with select neurological disorders. Overall, this research project will seek to synthesize current knowledge on EEG-guided anesthesia in patients with neurological disorders to potentially more accurately adapt to real-time fluctuations in patients' responses to anesthetic agents.
Successful anesthesia administration relies on various real-time monitoring, such as heart rate and respiratory rate, to adjust treatment for how a patient may respond to a specific anesthetic medication. This insight into the physiological state of the patient allows for more informed anesthesia administration. EEG utilization potentially provides another line of insight into the state of a patient under anesthesia, by giving real-time insight into the electrical activity of a patient's brain. EEG-guided anesthesia has been implemented variably in the past in populations that may be at higher risk or have more stringent anesthetic needs, such as children, but the use of EEG during anesthesia administration is currently unstandardized. It can be a valuable asset in providing individualized dosages and treatment regimens by providing another stream of data, and anesthesiologists can monitor for reactivity to administered anesthetics. In this review, we are examining how EEG has been applied in patients with specific neurological conditions, such as TBIs or Alzheimer's disease, with a goal of identifying its role as real-time monitoring method in this higher-risk population.
MAIN BODY:
This scoping review project aims to examine EEG-guided anesthesia in patients with pre-existing neurological conditions with the aim of identifying its potential to improve perioperative outcomes. We conducted a search using multiple databases on topics relating to anesthetic complications, EEG-guided anesthesia, or patients with select neurological disorders. A preliminary review on relevant literature suggests that EEG-guided anesthesia could benefit patients with certain neurological conditions that have a higher likelihood of anesthetic complications than the general population, such as increased postoperative confusion and delirium. In healthy patients, general anesthesia affects the EEG by causing dose-dependent slowing of rhythms, with higher dosing showing burst suppression patterns, which can be used as markers to guide dosing. Neurological disorders can impact baseline EEG readings, such as having a lower alpha/theta ratio in patients with Alzheimer's Disease compared to healthy patients at rest.
CONCLUSION:
EEG-guided anesthesia may provide benefits in accurate dosing of anesthetics to minimize the risk of over-sedation or under-sedation and their associated complications, but disease-specific considerations are necessary to be able to practically improve outcomes in patients who present with altered baseline EEG readings. As part of our continued approach, a systematic search using multiple databases, including PubMed, will be done and articles will be included and excluded based on relevance. Articles will be synthesized to map the current state of EEG-guided anesthesia integration and benefit for patients with select neurological disorders. Overall, this research project will seek to synthesize current knowledge on EEG-guided anesthesia in patients with neurological disorders to potentially more accurately adapt to real-time fluctuations in patients' responses to anesthetic agents.