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Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals pp 169–191Cite as

EEG Monitoring

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Abstract

Monitoring the nervous system begs two questions: what is the function of the nervous system, and how can it be observed to fulfill the promise of monitoring? A simple, yet practical answer to the first question is that the function of the nervous system is to create human behavior. To monitor is to implicitly assume that detecting untoward events in a timely fashion will allow for successful therapeutic intervention. Under the usual circumstances then, the answer to the second question is conversation or visual inspection of behavior (a conventional neurologic exam). During general anesthesia, a novel behavioral state is therapeutically induced to allow safe, tolerable, and meticulous surgery. In this state of general anesthesia, nervous system function is reversibly depressed as are most of the visible signs of CNS function. A few physiologic signs can be detected and have long been used as a guide to dosing anesthetics. Unfortunately, as the pharmaceutical choices expanded beyond diethyl ether, these physical signs varied widely between agents, making simple observation of outward signs of patient behavior inadequate as a dosing guide. The complete blockade of these signs by the introduction of muscle relaxants further complicated assessment of anesthetic action. During surgery and anesthesia, there are circumstances where the well-being of the brain or spinal cord may be put at risk. Examples include distraction of the spinal column, or clamping of the carotid artery. While tolerated by most patients, some will be injured by these procedures, and early warning may prevent permanent injury. The anesthesia practitioner may also benefit from monitoring because of the possibility of objective control over the state of anesthesia. General anesthesia is a continuum and varies not only with dose vs. a patient’s individual sensitivity, but also with dynamic changes in surgical stimulation. Clinical problems result from too little or too much anesthetic.

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  1. Blue Sky Medicine, LLC, 236 Candler Way, Williamson, GA, 30292, USA

    Ira J. Rampil M.S., M.D.

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  1. Ira J. Rampil M.S., M.D.
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Correspondence to Ira J. Rampil M.S., M.D. .

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  1. Departments of Anesthesiology, Neurological Surgery and Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Antoun Koht

  2. Department of Anesthesiology, University of Colorado School of Medicine, Aurora, Colorado, USA

    Tod B. Sloan

  3. Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA

    J. Richard Toleikis

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Rampil, I.J. (2017). EEG Monitoring. In: Koht, A., Sloan, T., Toleikis, J. (eds) Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals. Springer, Cham. https://doi.org/10.1007/978-3-319-46542-5_10

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