The Role of Processed Electroencephalogram in Adult Surgical Procedures: A Retrospective Cohort Study-The Role of Processed Electroencephalogram in Adult Surgical Procedures: A Retrospective Cohort Study

The Role of Processed Electroencephalogram in Adult Surgical Procedures: A Retrospective Cohort Study

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The article from the AANA Journal explores the utilization of processed electroencephalogram (pEEG) monitoring during general anesthesia. This retrospective cohort study is based on data from a large academic medical center, aiming to determine how frequently anesthesia professionals use pEEG and the factors influencing its use. The study analyzes patient, anesthetic, surgical characteristics, and healthcare provider influence.<br /><br />pEEG can reduce the risk of unintended awareness during anesthesia, a condition reported to affect approximately two per 1,000 patients, which can lead to severe psychological effects like posttraumatic stress disorder. Despite its benefits and recommendations for its use particularly in procedures involving neuromuscular blocking agents (NMBAs) and total intravenous anesthesia (TIVA), pEEG is not universally included in anesthesia monitoring standards by major organizations.<br /><br />The study involved 161,986 surgical procedures from April 2016 through April 2022, with data abstracted from electronic medical records. It found considerable variability in pEEG usage, with significant influence stemming from provider discretion. Older patients, those with higher ASA scores, recipients of TIVA, and patients undergoing specific surgeries like cardiac procedures were more likely to have pEEG monitoring. However, a comprehensive understanding of why some professionals choose to use pEEG more frequently is lacking.<br /><br />The authors suggest that structured guidelines and education at national and institutional levels could standardize pEEG use, enhancing patient safety and reducing the risks associated with AWR. The study highlights a gap in standardized monitoring protocols and underscores the need for further research to understand provider preferences and motivations behind pEEG use. Although conducted at a single medical center, the findings offer essential insights into the current practices surrounding pEEG monitoring.

Keywords

processed electroencephalogram

pEEG monitoring

general anesthesia

retrospective cohort study

anesthesia awareness

neuromuscular blocking agents

total intravenous anesthesia

patient safety

provider discretion

standardized guidelines