The Nurse Anesthesia Podcast
We discuss anesthesia related concepts, CRNA school, anesthesia clinical practice, anesthesia case management, crisis management, and anything that pertains to the practice of anesthesiology.
The Nurse Anesthesia Podcast
Ep 49: Index to Insight - EEG Optimized Anesthesia Delivery
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In this episode of The Nurse Anesthesia Podcast, host Jeremy Heiner, is joined by co-host Mark Gabot, and special guest Zohn Centimole, PhD, CRNA, for a practical discussion about moving “beyond the BIS Index number” and using electroencephalography (EEG) to better understand the brain’s response to anesthesia. The conversation explores how raw and processed EEG can provide anesthesia professionals with a real-time window into the organ they are actually anesthetizing—the brain.
Jeremy, Mark, and Zohn then break down the characteristic EEG frequencies encountered during anesthesia. They talk about burst suppression, the density spectral array (DSA), and how recognizing patterns may allow clinicians to titrate anesthetics more thoughtfully and individualize care rather than relying exclusively on MAC values, vital signs, or traditional dosing strategies.
The takeaway is simple: let’s start looking at the EEG! Put the monitor on, observe the changes from induction through emergence, correlate the patterns with anesthetic interventions, and begin developing the skills necessary to use brain monitoring as another tool for individualizing anesthesia care.
References
1. Aldecoa C, Bettelli G, Bilotta F, et al. Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients. Eur J Anaesthesiol. 2024;41(2):81-108. doi:10.1097/EJA.0000000000001876
2. Jegarl AM, Walline MC, Goldstein PA, Safavynia SA. Is Electroencephalographic Burst-Suppression Good, Bad, or Indifferent for Brain Health? Context Matters. Anesth Analg. 2026;142(6):1169-1179. doi:10.1213/ANE.0000000000007739
3. Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical Electroencephalography for Anesthesiologists: Part I: Background and Basic Signatures. Anesthesiology. 2015;123(4):937-960. doi:10.1097/ALN.0000000000000841
4. Xu A, Arnaout B, Scott DA, McGuigan S. Intraoperative electroencephalogram-derived measures and their association with postoperative delirium: a systematic review and meta-analysis. Br J Anaesth. 2025;135(6):1684-1703. doi:10.1016/j.bja.2025.08.038
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The Nurse Anesthesia Podcastis for educational and informational purposes only. It does not constitute medical. We continuously strive for accuracy, however, medicine is constantly evolving, and clinical decisions should always be made based on current guidelines, institutional policies, and individual patient considerations. The views expressed are those of the hosts and guests, and Do NOT necessarily reflect the opinions of any affiliated institutions. Listeners should consult their own healthcare providers before making any medical decisions.
Music by Alex Grohl