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Anes 507 > EEG Monitors > Flashcards

EEG Monitors Flashcards

1
Q

Reducing Risks in Anesthesia: Training

A

Education of Anatomy and Physiology
Equipment and Clinical measurement education
Progressive assessment and communication skills
Being vigilant, managing fatigue, asking questions

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2
Q

Reducing Risks in Anesthesia: Intra-Op

A 
Scan equipment regularly
Avoid wrong drug administration
Rapidly respond to improper anesthesia 
Minimize muscle relaxant 
Consider using EEG monitors
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3
Q

Risk Factors for Surgery Awareness: Surgery Type

A

General Anesthesia: 32%
Obstetrics: 28%
Gynecology: 18%
Other: 22%

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4
Q

Reasons for Surgical Awareness:

A

Faulty Anesthetic Technique: 70%
Failure to Check Equipment: 20%
Other: 10%

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5
Q

Goals of Satisfactory Anesthesia

A

Adequate perfusion of all organ systems
Unresponsive to noxious stimuli
Adequate cardiovascular and respiratory stability
Ideally no, or at least only minimal, patient movement
No awareness or recall of events during the procedure

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6
Q

Cortical Phenomenon

A

Conciousness

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7
Q

Sub Cortical Phenomenon

A 
Movement (cord reflex)
Hemodynamic responses (HR, BP) (brain stem)
Endocrine responses (surgical stress)
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8
Q

Methods of Monitoring Anesthesia Depth

A

Autonomic and Motor signs
MAC level
EEG and processed EEG
Electromyography

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9
Q

Autonomic Indicators of Anesthetic Depth

A

Vital Sign Invariability, when stimulus is observed or suspected
Heart Rate
Blood Pressure
Mydriasis (dilation of the pupil of the eye)

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10
Q

Meyer-Overton Correlation

A

Anesthesia commences when a chemical substance reaches a certain molar concentration in the hydrophobic phase (Anesthesia is produced by the partial pressure of the anesthetic agent in brain tissue)

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11
Q

Why do we use ED50 over ED95?

A

Because values slightly over ED50 typically result in loss of movement of most patients

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12
Q

Factors that decrease MAC levels

A 
Hypothermia (animals)
Advanced age (Humans)
Opioids, Ketamine (Humans)
Intravenous anesthetics (Humans)
a2 agonists
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13
Q

Factors that increase MAC Levels

A

Alcoholism
Young age (humans)
Hyperthermia (animals)

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14
Q

Factors that don’t affect MAC Levels

A

Gender

Duration of anesthesia exposure

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15
Q

Why do Redheads require more anesthetics

A

They just do (on average 20% more)

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16
Q

What does the EEG measure

A

Cortical activity derived from excitatory and inhibitory postsynaptic activity

17
Q

Alpha Band Frequency

A

8-12 Hz

Resting, awake, eyes closed

18
Q

Beta Band Frequency

A

> 12 Hz

Mental Activity, Sedation, Light Anesthesia

19
Q

Theta Band Frequency

A

4-7 Hz

Light Sleep, Light Anesthesia

20
Q

Delta Band Frequency

A
21
Q

BI-Spectral Index

A

Single Channel EEG data from 3 or 4 electrode sensor placed over the frontal cortex.
Differential amplifier measures the potential difference between electrodes 2 and 3
Electrode 1 is the ground (reference)
Electrode 4 is used in noise reduction

22
Q

Derivation of BIS

A

Burst Suppression Ratio
Relative Alpha/Beta ratio
Bicoherence of EEG

23
Q

BIS(#)

A

Ranges from 0 to 100, 0 is unconscious to 100 fully awake

24
Q

SQI (signal quality index)

A

Ranges from 0 to 100% This is the percentage of good epochs in the last 60 that could be used for calculation of the BIS.

25
Q

EMG

A

Electrical power in the 70-110 Hz range (given in dB with trend and bar graph)

26
Q

SR (Suppression Ratio)

A

Percentage of epochs in the past 63 seconds in which the EEG signal is considered suppressed

27
Q

Trend(s)

A

Graphic Display

28
Q

Limitations of BIS monitor

A
  • 60Hz, ECG/pacemaker, and EMG signals tend to increase the BIS number artifactually
  • Hypothermia and cerebral ischemia appear identical to deep sedation and decrease the BIS number
  • Not useful during N2O and Ketamine anesthesia?
  • Little data on high dose opioids
29
Q

Incidence of awareness w/ BIS

A

Estimated to be 0.1% to 0.2% (elective and emergency surgery).

30
Q

Entropy in EEG

A

Entropy describes the irregularity or complexity or unpredictability characteristics of a signal. When the patient is awake, EEG is highly irregular and the amount of entropy is very high. As the patient goes into deeper planes of anesthesia, EEG will have more regular pattern of wave forms which brings down entropy

Anes 507 (9 decks)

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