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Office of Continuing Professional Development

Clinical Electroencephalography for the Anesthesiologist

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This program on Clinical Electroencephalography for Anesthesiologists is based on a two-lecture series developed by Drs. Patrick L. Purdon and Emery N. Brown to teach anesthesiologists at Massachusetts General Hospital how to read the electroencephalogram (EEG) to track the brain states of patients receiving general anesthesia or sedation. It is built around the belief that the EEG should be presented in a way that makes it easy to read, that is physiologically-principled, and that fits into the framework of current clinical practice.

To make the EEG both easier to read and more informative, Drs. Purdon and Brown introduce a toolthe spectrogramthat makes the anesthesia-related oscillations in the EEG signal clearly visible. Anesthesiologists know that different anesthetic drugs have different mechanisms and properties. With this new approach, anesthesiologists will see that different drugs have different "EEG signatures" as well, and that the signatures relate to the mechanisms through which the drugs act in the brain. With practice, these signatures become easy to recognize, and provide an instantaneous readout of a patient's brain state under anesthesia. This information is readily applicable to clinical practice using existing EEG-based anesthetic monitors.

In the first one and ahalfhour module of this two-part series, we discuss basic principles of the EEG and describe the EEG signatures for propofol, the ether-derived anesthetics, dexmedetomidine, ketamine, and nitrous oxide. In the second one and ahalfhour module, we discuss different combinations of these drugs and provide examples of intraoperative management.

Learning Objectives

Upon completion of this activity, participants will be able to:

1. Learn the basic EEG spectral signatures and waveform patterns associated with commonly used anesthetic drugs
2. Learn how these EEG features relate to the underlying mechanisms and properties associated with these drugs
3. Become familiar with patterns and case studies of anesthetic combinations typically used in clinical practice.

Target Audience

Anesthesiologists, Anesthesia Residents, Critical Care Physicians, Certified Registered Nurse Anesthetists, Critical Care Nurses

Registration Information

This activity is free of charge.

Forquestions regarding registration, please contact Partners Office of Continuing Professional Development at


Patrick L. Purdon, Ph.D.
Associate Bioengineer
Massachusetts General Hospital
Assistant Professor of Anaesthesia
Harvard Medical School
Department of Anesthesia, Critical Care, and Pain Medicine

Emery N. Brown, M.D., Ph.D.
Professor of Computational Neuroscience and Health Sciences and Technology
Department of Brain and Cognitive Sciences
MIT-Harvard Division of Health Sciences and Technology

Nathaniel M. Sims, M.D.
Assistant Professor of Anaesthesia
Harvard Medical School
Department of Anesthesia, Critical Care, and Pain Medicine

CME Information

Start Date:May 13, 2014
End Date: May 11, 2017

Review Dates: May 12, 2015; April 14, 2016
Reviewed by:Patrick L. Purdon, PhD

Partners HealthCare System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Partners HealthCare System designates this enduing material activity for a maximum of 1.5AMA PRA Category 1 Credits.Physicians should claim only the credit commensurate with the extent of their participation in the activity.


In accord with the disclosure policy of Partners HealthCare System as well as guidelines of the Accreditation Council for Continuing Medical Education (ACCME), planners, speakers and anyone who may have an influence on the content of the activity have been asked to disclose any relationship they or their spouse/partner have to companies producing pharmaceuticals, medical equipment, devices, etc. that may be germane to the content of their presentation. Such disclosure is not intended to suggest or condone bias, but provides participants with information that might be of potential importance to their evaluation of a given presentation.

Partners HealthCare System has implemented a process to resolve potential COIs for this CME activity to help ensure content objectivity, independence, fair balance and ensure that the content is aligned with the interest of the public.

The following planners, reviewers and content developersand/or their spouse/partner have reported a relevant financial relationship with a commercial interest:

Patrick L. Purdon, Ph.D., Planner, Reviewer
Inventor, Personal and laboratory shares of institutionally-distributedtechnology patent licensing royalties:Masimo Corporation
Speaker:Masimo Corporation

Emery N. Brown, M.D., Ph.D., Planner
Inventor, Personal and laboratory shares of institutionally-distributedtechnology patent licensing royalties:Masimo Corporation
Speaker Honoraria:Masimo Corporation

The following planner and content developer and/or their spouse/partner have reported no relevant financial relationship with a commercial interest:

Nathaniel M. Sims, M.D.

The following planner and/or their spouse/partner have reported no relevant financial relationship with a commercial interest:

Christopher Colvin

Hardware/Software Specifications:
This internet-based CME activity is best experienced Microsoft Internet Explorer 9.0 or later, Mozilla Firefox 13 or later, Chrome 16 or later, Safari (version 5 or later)

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, and Microsoft PowerPoint.

Optimal System Configuration:
Flash Player: Adobe Flash Player 10.1+
Browser: Firefox 13+, Internet Explorer 9.0+, Safari 13+, or Google Chrome 16+
Operating System: Windows Vista,7,8 or Mac OS X 10.4+
Internet Connection: 1 Mbps or higher

Minimum Requirements:
Windows PC:
Intel Pentium 4 or equivalent with 2.33 GHz processor; Windows XP; 512 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 3+, Internet Explorer 7.0+, Safari 4+, Google Chrome, or Opera
Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 128MB of video memory; Sound Card: at least 16-bit

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