Episode 154: EEG monitoring with Dr. Emery Brown

In this 154th episode I welcome Dr. Emery Brown to the show to discuss how we monitor the depth of anesthesia. We discuss the drawbacks to BIS and why Dr. Brown thinks the EEG itself is the best way to go.

References:

EEG reading tutorials: https://eegforanesthesia.iars.org/

Purdon et al: The Ageing Brain: Age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia

Brown et al: General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis. Annu. Rev. Neurosci. 2011.

Brown et al: General Anesthesia, Sleep, and Coma. NEJM. 2010.

Brown et al: Multimodal General Anesthesia: Theory and Practice. A&A 2018.

Purdon et al: Clinical Electroencephalography for Anesthesiologists. Part I: Background and Basic Signatures. Anesthesiology 2015.

Dental Anesthesia info:

Contacts:

Thomas Whitmer: thomas.whitmer.tw@gmail.com

Mana saraghi: msaraghi@gmail.com

References:

https://www.ada.org/en/ncrdscb/dental-specialties/specialty-definitions

http://www.ada.org/~/media/CODA/Files/anes.ashx

American Society of Dentist Anesthesiologists website: https://www.asdahq.org

Virtual tour https://www.youtube.com/watch?v=ZJ1Mo65ah4w&feature=youtu.be



2 Replies to “Episode 154: EEG monitoring with Dr. Emery Brown”

  1. I think there are some misconceptions about MAC value in this episode.
    MAC is reffered as value for monoanesthesia with a volatile anesthetic, which is rare now, so I wouldn’t say it is wrong, but rather outdated for modern anesthesia practice, would you agree on that? Moreover, modern books (referring to Morgan) provide with MAC value for preventing movement in 95% of patients, but still as a monoanesthetic.

    Still an amazing episode as usual, thank you for your work!

    1. Thanks for the thoughts Dimitri. I think Dr. Brown’s point was that some people see 1 MAC as a goal and, at least for a sole anesthetic, that would mean 50% of patients would move. But your point that we rarely use single agent anesthesia is true, and that makes MAC hard to interpret. I think that’s why Dr. Brown prefers EEG monitoring.

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