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.”

About the Activity:

This activity is made up of 3 courses:

Basics of Clinical EEG for General Anesthesia and Sedation (up to 3 CME offered)
This course will introduce you to this new neurophysiologically based paradigm for brain state monitoring of patients’ receiving anesthesia care.

Anesthesia EEG Case Studies (up to 3 CME offered)
This second course will present EEG waveforms and spectrograms from actual clinical cases and ask you to apply what you have learnt from the first course to evaluate the observed EEG patterns.

Clinical EEG for Anesthesia Management of Elderly Patients (up to 3 CME offered)
This third course will build upon the material presented in the first course and aim to provide an introductory look at some age-related changes to the brain and how the EEG signal during anesthesia may change as a result of typical aging. Each course is associated with its own CME. All 3 courses consist of a series of “lesson” questions, which are not graded, followed by a series of “assessment” questions. Learners must score at least 80% on the assessment questions in order to receive CME for the course. Upon answering questions, learners are presented with a detailed explanation for the correct response, including relevant references for follow-up.

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.
  5. Apply concepts described above to a variety of case studies and assess EEG patterns observed in these cases.
  6. Observe age-related changes to the brain and how the EEG signal during anesthesia may change as a result of typical aging.

Estimated Completion Time:

Basics of Clinical EEG for General Anesthesia and Sedation
This module consists of 66 ungraded “lesson” questions and 21 graded “assessment” questions. It is also recommended that people new to the material review the short introductory video series and read the 2015 Anesthesiology review article “Clinical Electroencephalography for Anesthesiologists – Part 1: Background and Basic Signatures”. The module is estimated to take up to 3 hours to complete.

Anesthesia EEG Case Studies
This module consists of 26 ungraded “lesson” questions and 26 graded “assessment” questions. The module is estimated to take up to 3 hours to complete.

Clinical EEG for Anesthesia Management of Elderly Patients
This module consists of 23 ungraded “lesson” questions and 17 graded “assessment” questions. The module is estimated to take up 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:

Prior to taking the course, it is recommended that those unfamiliar with the EEG, how it relates to anesthetic brain state, and the neurophysiological mechanisms of common anesthetic drugs (i.e. propofol, inhaled ether-derived anesthetics, dexmedetomidine, and ketamine) review the 2015 article “Clinical Electroencephalography for Anesthesiologists – Part 1: Background and Basic Signatures.” There is also a series of short, animated videos that provide a quick introduction to some essential concepts for using the EEG for anesthesia management. These videos can be accessed from the home screen of the course.

Optional first steps:

  1. Review the short introductory videos. (OPTIONAL)
  2. Read the review article “Clinical Electroencephalography for Anesthesiologists – Part 1: Background and Basic Signatures.” (OPTIONAL)

Each course is associated with its own CME. All 3 courses consist of a series of “lesson” questions, which are not graded, followed by a series of “assessment” questions. Learners must score at least 80% on the assessment questions in order to receive CME for the course.

To complete the activity the learner should, in order, for each course:

  1. Complete the course lesson questions.
  2. Complete the post-test assessment questions. A minimum score of 80% is required.
  3. Complete the associated activity evaluation.
  4. 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). The IARS is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statements

  1. The IARS designates this Enduring Material activity, Basics of Clinical EEG for General Anesthesia and Sedation, for a maximum of 3 AMA PRA Category 1 Credits.™
  2. The IARS designates this Enduring Material activity, Anesthesia EEG Case Studies, for a maximum of 3 AMA PRA Category 1 Credits.™
  3. The IARS designates this Enduring Material activity, Clinical EEG for Anesthesia Management of Elderly Patients, for a maximum of 3 AMA PRA Category 1 Credits.™

Physicians should claim only the credit commensurate with the extent of their participation in each 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 is provided with commercial support from Masimo.