Brain monitoring with electroencephalography and the electroencephalogram- derived bispectral index during cardiac surgery

M. Kertai, Elizabeth L. Whitlock, Michael S. Avidan

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Cardiac surgery presents particular challenges for the anesthesiologist. In addition to standard and advanced monitors typically used during cardiac surgery, anesthesiologists may consider monitoring the brain with raw or processed electroencephalography (EEG). There is strong evidence that a protocol incorporating the processed EEG bispectral index (BIS) decreases the incidence intraoperative awareness in comparison with standard practice. However, there is conflicting evidence that incorporating the BIS into cardiac anesthesia practice improves "fast-tracking," decreases anesthetic drug use, or detects cerebral ischemia. Recent research, including many cardiac surgical patients, shows that a protocol based on BIS monitoring is not superior to a protocol based on end-tidal anesthetic concentration monitoring in preventing awareness. There has been a resurgence of interest in the anesthesia literature in limited montage EEG monitoring, including nonproprietary processed indices. This has been accompanied by research showing that with structured training, anesthesiologists can glean useful information from the raw EEG trace. In this review, we discuss both the hypothesized benefits and limitations of BIS and frontal channel EEG monitoring in the cardiac surgical population.

Original languageEnglish
Pages (from-to)533-543
Number of pages11
JournalAnesthesia and Analgesia
Volume114
Issue number3
DOIs
Publication statusPublished - Mar 2012

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Thoracic Surgery
Electroencephalography
Brain
Anesthetics
Anesthesia
Intraoperative Awareness
Brain Ischemia
Research
Incidence
Population
Anesthesiologists

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Brain monitoring with electroencephalography and the electroencephalogram- derived bispectral index during cardiac surgery. / Kertai, M.; Whitlock, Elizabeth L.; Avidan, Michael S.

In: Anesthesia and Analgesia, Vol. 114, No. 3, 03.2012, p. 533-543.

Research output: Contribution to journalArticle

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