International Anesthesia Research Society

Continuing Medical Education (CME) Activity Information

Educational Need

During general anesthesia and sedation, there are highly structured patterns that can be observed by using an electroencephalogram (EEG). These patterns relate to different states of altered arousal. Furthermore, we can relate these patterns to the physiological actions of different anesthetic drugs on specific molecular targets, in specific neural circuits of the brain. With proper training and experience you can recognize these EEG patterns and use them to provide tailored, “personalized anesthesia care”. This module will introduce you to this new neurophysiologically based paradigm for brain state monitoring of patients’ receiving anesthesia care.

This module will cover the essential information for understanding the biophysics of the EEG and what is represented in the EEG waveform and spectrogram. Content will also cover the link between the neurophysiological mechanisms and EEG signatures of most of the major drugs used in anesthesiology - propofol, dexmedetomidine, ketamine, and 4 inhaled anesthetics: sevoflurane, isoflurane, desflurane, and nitrous oxide. This course will serve as the basis for understanding all the other modules in this series.

This module will primarily build upon the material covered in Drs. Patrick L. Purdon and Emery N. Brown’s 2015 Anesthesiology review article “Clinical Electroencephalography for Anesthesiologists – Part 1: Background and Basic Signatures”. https://www.ncbi.nlm.nih.gov/pubmed/26275092

If you are unfamiliar with the EEG and how it relates to anesthesia, and the neurophysiological mechanisms of common anesthetic drugs (e.g. propofol, sevoflurane, dexmedetomidine, and ketamine) we suggest you review this article and view the short video series on this site prior to starting this course.

Target Audience

The material taught in this course is essential content for anesthesiologists and anesthesia residents, both within the United States and internationally. In addition, Certified Registered Nurse Anesthetists (CRNA), Student Registered Nurse Anesthetists (SRNA), critical care physicians, and critical care nurses may benefit from the material taught within this course.

Learning Objectives

  1. Describe the general biophysics of what the EEG is detecting and demonstrate the relationship between the EEG waveform and spectrogram.
  2. Interpret the typical EEG waveform and spectrogram patterns associated with commonly used anesthetic drugs.
  3. Discuss the different underlying neurophysiological mechanisms of how commonly used anesthetic drugs produce anesthesia effects. Extrapolate how these different mechanisms relate to the unique EEG patterns of the different drugs.
  4. Identify patterns associated with common EEG artifacts that may arise due to electrode placement or specific surgical activities.

Estimated Completion Time

The “Basics of Clinical Electroencephalography (EEG) for General Anesthesia and Sedation” module consists of 66 questions, and a post-test. In addition, prior to attempting the questions it is recommended that you review the short introductory video series and read the 2015 Anesthesiology review article “Clinical Electroencephalography for Anesthesiologists – Part 1: Background and Basic Signatures” (https://www.ncbi.nlm.nih.gov/pubmed/26275092). The entire course should take approximately 2.5 to 3 hours to complete.

Disclosure Information

Patrick L. Purdon, Ph.D. & Emery N. Brown, M.D. Ph.D. - Planners, Reviewers
Drs. Purdon and Brown are inventors on pending on systems and methods using the electroencephalogram to monitor the anesthetic states of the brain. Use of one of these patents has been licensed by Massachusetts General Hospital non-exclusively to Masimo. Drs. Purdon and Brown received institutionally-distributed royalties on this license.

Christopher Colvin, MHSc. - Planner, Content Developer
No relevant financial relationships with a commercial interest.

Activity Completion Information

This activity consists of a series of questions. For those unfamiliar with electroencephalography (EEG) and how EEG relates to anesthesia and common anesthetic drugs we recommend watching the short introductory video series posted on this site. We also recommend reading the 2015 Anesthesiology review article “Clinical Electroencephalography for Anesthesiologists – Part 1: Background and Basic Signatures” (https://www.ncbi.nlm.nih.gov/pubmed/26275092).

To complete the activity the learner should, in order:

  1. Review the short introductory videos. (OPTIONAL)
  2. Read the review article “Clinical Electroencephalography for Anesthesiologists – Part 1: Background and Basic Signatures”. (OPTIONAL)
  3. Complete the 66 course content questions.
  4. Complete the post-test questions. A minimum score of 80% is required.
  5. Complete the associated activity evaluation.
  6. Complete the attestation of participation and retrieve the certificate of completion.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the International Anesthesia Research Society (IARS) and Massachusetts General Hospital. The IARS is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

The IARS designates this Enduring Material activity for a maximum of 5 AMA PRA Category 1 Credits.™ Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Maintenance of Certification in Anesthesiology Program. (MOCA.)

Physicians wishing to have credits from this educational activity reported to the ABA for the ABA MOCA® Patient Safety CME Credit Program may do so by entering their eight digit ABA identification number when claiming CME credit. The IARS forwards credits to the ABA on a quarterly basis.

Disclosure

The IARS makes every effort to develop CME activities that are independent, objective, scientifically balanced presentations of information. The information provided in this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a health care provider relative to diagnostic and treatment options of a specific patient’s medical condition.

Commercial Support

This activity was developed with support through an educational grant from Masimo Corporation.