Full Description
Is there a unified definition of anesthesia? What exactly are we monitoring? Processed electroencephalography (pEEG) monitors may not reliably assess all anesthetic endpoints. This book explains how anesthesiologists should not blindly follow the displayed numbers when they adjust their anesthetic agents' doses. This book is based on the author's 30 years of experience researching the topic of Depth of Anesthesia (DOA) monitoring. Depth of Anesthesia monitors are pEEG Monitors. All conditions that would alter the EEG (these are many) would also alter the DOA displayed numbers so each reader should learn how to correctly interpret the displayed numbers.
In many instances physicians are confronted with various paradoxical Depth of Anesthesia monitors displaying inaccurate readings that do not concur with "clinically judged Anesthetic state" whether arising from an underlying pathophysiology alteration of the patients' own EEG cerebral function or those due to shortcomings in the performance and design of the DoA.
This book - very easy to read although the topic sounds very complicated - would like to represent a reference where anesthesiologists can go back to when they are confronted with such situations. Each chapter is focused on one contributing element that could influence depth of anesthesia monitoring. It reports cases or studies of displayed numbers that do not concur with clinically assessed depth of anesthesia; these are immediately followed by the documented scientific EEG explanations.
A book that both younger and older anesthetists should read to better understand how to use DOA monitors in their daily practice and that very much simplifies the topic.
Contents
1. Depth Of Anesthesia (DOA) Monitors. History and Basic Structures.- 2. "Monitors" Terminologies.- 3. "Anesthesia" Definitions.- 4. Paradoxical Inhalational anesthetics, Nitrous Oxide, Ketamine and Propofol.- 5. Clinical Conditions that could alter processed electroencephalography depth of anesthesia monitoring.- 6. Effect of electromyographic (EMG) activity and Neuromuscular Blocking Agents (NMBAs) on Depth of Anesthesia monitoring. Achilles First Heel.- 7. Effect of Noxious stimulation and Anti-noxious Opioids on Depth of Anesthesia monitoring. Achilles Second Heel (!).- 8. Off-label use of bispectral index to grade conditions other than Depth of Anesthesia.- 9. Natural sleep and sedation monitoring in critically ill patients.- 10. Artificial Intelligence-Machine learning (AI-ML), Concerto 3-channels Closed-Loop automated system.
