The Electroencephalogram In Anesthesia

Neurological, neurovegetative, and psychic changes following surgery or in tensive care indicate alterations in cerebral function. When these changes are analyzed exactly, they are found to be by no means rare; at the same time, they present a wide spectrum of clinical manifestations. While optimal circulatory monitoring - including continuous EEG recording during anes thesia or intensive care - is today regarded as routine, the problem of objec tive and continuous monitoring of cerebral function under various forms of anesthesia, surgery, and intensive care has not been solved. Considerable improvements in clinical neurophysiology, mainly through visual and spectral analytic evaluations of the EEG, show func tional neurophysiological changes to be equivalent to, or the cause of, clinical, neurological, and psychic changes. The question of current interest, therefore, is whether anesthesiological EEG monitoring is able, both theo retically and practically, to detect and adequately interpret cerebral altera tions following perioperative measures such that these alterations can be treated or avoided accordingly. In the long run, the basic questions are to what extent can anesthesiological measures be guided by the EEG pattern and managed effectively, and can EEG analysis be significant both for the individual patient and in the general interpretation of the effect of anes thesiological procedures? Questions of the relevance and practicability of anesthesiological EEG monitoring are dealt with in this book. This study is based on an analysis of more than 1500 EEGs of patients who underwent anesthesia during surgery.

This book describes the developments and improvements in electroencephalography (EEG). In recent years, digital technology has replaced analog equipments, and it is now possible to easily record and store EEG tracings and to quickly recall previously acquired material for subsequent analysis. In addition, not only static figures, but also electronic supplementary materials can be included in books, enabling EEGs to be viewed in real-time. In clinical practice, EEG still represents the most important functional examination in the study CNS development and its anatomical and physiological integrity throughout life. In the pathological context, EEG provides indispensable diagnostic information for classification of epileptic syndromes, and it is also valuable in all the other CNS diseases (infectious, cerebrovascular, neurodegenerative, etc). Furthermore, monitoring EEG can be widely used in emergency settings, such as emergency departments or intensive care units. In comatose patients, EEG provides information regarding prognosis and evaluation of the sedative effect of anesthetic drugs. Written by a group of leading national and international experts, it offers a substantial, yet practical, EEG compendium, which serves as a reference resource for physicians and neurodiagnostic technologists as well as physicians-in-training, researchers, practicing electroencephalographers and students.

Research in electrophysiologic monitoring in anesthesia and intensive care has focussed mostly on questions pertinent for patient care: First how to quantitate drug effects on brain electrical activity and the degree of anesthetic-induced suppression of the central nervous system. Second, how to monitor functional impairment following cerebral ischemia and hypoxia. And third, how to differ entiate between drug-induced effects on the central nervous system and deleteri ous events related to reductions in cerebral blood flow and/or oxygen delivery. Even though progress has been achieved over the last 10 years in this field and fascinating new techniques have been developed, it is still not clear which monitor parameter will provide adequate information on the depth of anes thesia and the analgesic level. Because the central nervous system has been one of the main research areas in our department over the last 10 years, we organized a workshop to summarize the latest developments in central nervous system monitoring. This book comprises the topics of this workshop and is intended to provide insight into the current status of central nervous system monitoring, elucidating possible indications and delineating its limitations.

This atlas offers a collection of EEG spectral analyses and their corresponding conventional recordings under anes thesio10gical procedures. The EEGs presented here were re corded on general surgical and gynecological patients during the last few years. Premedication, induction and maintenance of anesthesia, recovery the immediate postoperative period, and intensive care are covered. Techniques for operating the necessary equipment and artefacts relevant to the routine clinical use of EEG are briefly outlined. Typical examples of characteristic EEGs are presented at the beginning of each chapter, followed by illustrations of deviations from the norm showing the great variety of anesthesiologically induced changes of cerebral function. The description of each EEG course is assessed in relation to clinical parameters. Sometimes no satisfactory interpreta tion can be made, because many physiological and patho physiological causes of alterations in cerebral function are unknown. Time and again it proves impossible to estimate wether deviations from the norm have their origin in cerebral changes or are secondary to extracerebra1 disturbances. The atlas comprises a complete survey in itself, but it can also be seen as a supplement to the book The Electroenceph alogram in Anesthesia by I. Pich1mayr, U. Lips, and H. Kunkel (Springer, 1983), in which detailed lists of references are quoted that are omitted here.

This volume presents the proceedings of the joint conference of the European Medical and Biological Engineering Conference (EMBEC) and the Nordic-Baltic Conference on Biomedical Engineering and Medical Physics (NBC), held in Tampere, Finland, in June 2017. The proceedings present all traditional biomedical engineering areas, but also highlight new emerging fields, such as tissue engineering, bioinformatics, biosensing, neurotechnology, additive manufacturing technologies for medicine and biology, and bioimaging, to name a few. Moreover, it emphasizes the role of education, translational research, and commercialization.

This is an introduction to the patient monitoring technologies that are used in today’s acute care environments, including the operating room, recovery room, emergency department, intensive care unit, and telemetry floor. To a significant extent, day-to-day medical decision-making relies on the information provided by these technologies, yet how they actually work is not always addressed during education and training. The editors and contributors are world-renowned experts who specialize in developing, refining, and testing the technology that makes modern-day clinical monitoring possible. Their aim in creating the book is to bridge the gap between clinical training and clinical practice with an easy to use and up-to-date guide. · How monitoring works in a variety of acute care settings · For any healthcare professional working in an acute care environment · How to apply theoretical knowledge to real patient situations · Hemodynamic, respiratory, neuro-, metabolic, and other forms of monitoring · Information technologies in the acute care setting · New and future technologies