Alternative mounting of electrodes for electroencephalographic monitoring of the depth of anesthesia in neurological surgery

Abstract

Background: Monitoring of the depth of anesthesia (DOA) has been limited to the frontal area; however, this could be affected by different surgical approaches especially when frontal approaches are made. We evaluate an alternative electroencephalographic mounting comparing the spectral edge frequency with the traditional mounting. Methods: A comparative cross-sectional study was carried out in 40 patients who underwent transcranial resection, endonasal resection and trigeminal neuralgia, microvascular decompression non-specific neurosurgery with total intravenous anesthesia. Both traditional frontal and central alternative mountings were performed in each patient, in order to evaluate if there was difference in the spectral edge frequency. The statistical analysis was performed using multivariate and correlation analysis, like sensitivity and specificity analyses. Results: The mean age of the patients was of 45.37 years (±13.7), 42.5% females and 57.5% males. There were no statistical difference between both mountings in terms of the anesthetic moment (p = 0.153), neither laterality (p = 0.446) by ANOVA test. A strong correlation between both assemblies was observed in the different anesthetic moments by Pearson correlation coefficient test. Sensitivity of 88% and specificity 40% were established for the alternative mounting. Conclusions: Alternative electroencephalographic mounting can be used for neuromonitoring, when the frontal mounting is not possible. Keywords: Electrodes, Electroencephalography, Neuroanesthesiology, Neurosurgery