Research progress on the depth of anesthesia monitoring based on the electroencephalogram

Abstract

General anesthesia typically involves three key components: amnesia, analgesia, and immobilization. Monitoring the depth of anesthesia (DOA) during surgery is crucial for personalizing anesthesia regimens and ensuring precise drug delivery. Since general anesthetics act primarily on the brain, this organ becomes the target for monitoring DOA. Electroencephalogram (EEG) can record the electrical activity generated by various brain tissues, enabling anesthesiologists to monitor the DOA from real-time changes in a patient's brain activity during surgery. This monitoring helps to optimize anesthesia medication, prevent intraoperative awareness, and reduce the incidence of cardiovascular and other adverse events, contributing to anesthesia safety. Different anesthetic drugs exert different effects on the EEG characteristics, which have been extensively studied in commonly used anesthetic drugs. However, due to the limited understanding of the biological basis of consciousness and the mechanisms of anesthetic drugs acting on the brain, combined with the effects of various factors on existing EEG monitors, DOA cannot be accurately expressed via EEG. The lack of patient reactivity during general anesthesia does not necessarily indicate unconsciousness, highlighting the importance of distinguishing the mechanisms of consciousness and conscious connectivity when monitoring perioperative anesthesia depth. Although EEG is an important means of monitoring DOA, continuous optimization is necessary to extract characteristic information from EEG to monitor DOA, and EEG monitoring technology based on artificial intelligence analysis is an emerging research direction.