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American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes: Electroencephalography.

Publication ,  Journal Article
Chan, MTV; Hedrick, TL; Egan, TD; García, PS; Koch, S; Purdon, PL; Ramsay, MA; Miller, TE; McEvoy, MD; Gan, TJ ...
Published in: Anesth Analg
May 2020

Electroencephalographic (EEG) monitoring to indicate brain state during anesthesia has become widely available. It remains unclear whether EEG-guided anesthesia influences perioperative outcomes. The sixth Perioperative Quality Initiative (POQI-6) brought together an international team of multidisciplinary experts from anesthesiology, biomedical engineering, neurology, and surgery to review the current literature and to develop consensus recommendations on the utility of EEG monitoring during anesthesia. We retrieved a total of 1023 articles addressing the use of EEG monitoring during anesthesia and conducted meta-analyses from 15 trials to determine the effect of EEG-guided anesthesia on the rate of unintentional awareness, postoperative delirium, neurocognitive disorder, and long-term mortality after surgery. After considering current evidence, the working group recommends that EEG monitoring should be considered as part of the vital organ monitors to guide anesthetic management. In addition, we encourage anesthesiologists to be knowledgeable in basic EEG interpretation, such as raw waveform, spectrogram, and processed indices, when using these devices. Current evidence suggests that EEG-guided anesthesia reduces the rate of awareness during total intravenous anesthesia and has similar efficacy in preventing awareness as compared with end-tidal anesthetic gas monitoring. There is, however, insufficient evidence to recommend the use of EEG monitoring for preventing postoperative delirium, neurocognitive disorder, or postoperative mortality.

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Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

May 2020

Volume

130

Issue

5

Start / End Page

1278 / 1291

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Societies, Medical
  • Recovery of Function
  • Quality of Health Care
  • Perioperative Care
  • Intraoperative Neurophysiological Monitoring
  • Humans
  • Electroencephalography
  • Consensus
 

Citation

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Chicago
ICMJE
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Chan, M. T. V., Hedrick, T. L., Egan, T. D., García, P. S., Koch, S., Purdon, P. L., … Perioperative Quality Initiative (POQI) 6 Workgroup, . (2020). American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes: Electroencephalography. Anesth Analg, 130(5), 1278–1291. https://doi.org/10.1213/ANE.0000000000004502
Chan, Matthew T. V., Traci L. Hedrick, Talmage D. Egan, Paul S. García, Susanne Koch, Patrick L. Purdon, Michael A. Ramsay, et al. “American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes: Electroencephalography.Anesth Analg 130, no. 5 (May 2020): 1278–91. https://doi.org/10.1213/ANE.0000000000004502.
Chan, Matthew T. V., et al. “American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes: Electroencephalography.Anesth Analg, vol. 130, no. 5, May 2020, pp. 1278–91. Pubmed, doi:10.1213/ANE.0000000000004502.
Chan MTV, Hedrick TL, Egan TD, García PS, Koch S, Purdon PL, Ramsay MA, Miller TE, McEvoy MD, Gan TJ, Perioperative Quality Initiative (POQI) 6 Workgroup. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes: Electroencephalography. Anesth Analg. 2020 May;130(5):1278–1291.

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

May 2020

Volume

130

Issue

5

Start / End Page

1278 / 1291

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Societies, Medical
  • Recovery of Function
  • Quality of Health Care
  • Perioperative Care
  • Intraoperative Neurophysiological Monitoring
  • Humans
  • Electroencephalography
  • Consensus