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Making brain monitoring routine: why processed EEG monitoring should be standard practice.

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Τίτλος: Making brain monitoring routine: why processed EEG monitoring should be standard practice.
Συγγραφείς: Berger-Estilita J; Institute for Medical Education, University of Bern, Mittelstrasse 43, +41 31 684 62 01, Bern, 3012, Switzerland. joanamberger@gmail.com.; Salem Spital, Hirslanden Medical Group, Bern, Switzerland. joanamberger@gmail.com.; Centre for Health Technology and Services Research, Faculty of Medicine, RISE-Health, University of Porto, Porto, Portugal. joanamberger@gmail.com.; Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. joanamberger@gmail.com., Absalom AR; Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Gelb AW; Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA.
Πηγή: Journal of clinical monitoring and computing [J Clin Monit Comput] 2026 Oct; Vol. 40 (5), pp. 965-973. Date of Electronic Publication: 2026 Jun 05.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Springer Country of Publication: Netherlands NLM ID: 9806357 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2614 (Electronic) Linking ISSN: 13871307 NLM ISO Abbreviation: J Clin Monit Comput Subsets: MEDLINE
Imprint Name(s): Publication: Amsterdam : Springer
Original Publication: Dordrecht, The Netherlands ; Boston : Kluwer Academic Publishers, c1998-
Ιατρικοί όροι (MeSH): Electroencephalography*/methods , Brain*/physiology , Monitoring, Intraoperative*/methods , Intraoperative Neurophysiological Monitoring*/methods, Anesthesia, General/methods ; Monitoring, Physiologic/methods ; Humans ; Patient Safety ; Anesthesia ; Signal Processing, Computer-Assisted
Περίληψη: Despite major technological advances and a growing evidence base, perioperative electroencephalographic (EEG) monitoring remains underused, even though general anaesthesia is fundamentally a brain-targeted intervention. Processed EEG (pEEG) captures clinically relevant brain physiology and provides actionable information to guide anaesthetic dosing, yet its adoption has been hindered by expectations of outcome certainty that exceed those applied to other standard monitors. Much of the controversy reflects misaligned endpoints-such as movement or binary awareness detection-rather than the domains in which EEG plausibly adds value, including avoidance of excessively deep anaesthesia and optimisation of drug titration. While large trials have produced heterogeneous results and have not demonstrated uniform benefit across broad surgical populations, some analyses have explored the possibility that EEG-guided anaesthesia may be more relevant in selected high-risk groups, particularly older adults vulnerable to postoperative neurocognitive disorders. Continued failure to integrate routine brain monitoring into standard anaesthetic practice may therefore pose a greater patient safety risk than adopting it in the setting of imperfect yet biologically coherent evidence.
(© 2026. The Author(s).)
Competing Interests: Declarations. Competing interests: JBE is Associate Editor-in-Chief of BJA Open. She received speakers’ fees from Medtronic (paid to the institution). AA is the financial trustee of the BJA company. JBE and AA are members of the Board of Directors of the European Society of Anaesthesiology and Intensive Care. AWG is past president of the World Federation of Societies of Anaesthesiology and has consulting agreements with Haisco Pharma, Medtronic, BD and Fresenius Kabi. All relationships are outside the submitted work. Declaration of Generative AI and AI-assisted technologies in the manuscript preparation process.: During the preparation of this work, the authors used ChatGPT v.5.2 to improve readability and grammar. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.
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Contributed Indexing: Keywords: Anesthesia, general; Electroencephalography; Monitoring, intraoperative; Patient safety; Postoperative delirium
Entry Date(s): Date Created: 20260605 Date Completed: 20260910 Latest Revision: 20260918
Update Code: 20260918
PubMed Central ID: PMC13562248
DOI: 10.1007/s10877-026-01453-9
PMID: 42247119
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1573-2614
DOI:10.1007/s10877-026-01453-9