Research in electrophysiologic monitoring in anesthesia and intensive care has focussed mostly on questions pertinent for patient care: First how to quantitate drug effects on brain electrical activity and the degree of anesthetic-induced suppression of the central nervous system. Second, how to monitor functional impairment following cerebral ischemia and hypoxia. And third, how to differ entiate between drug-induced effects on the central nervous system and deleteri ous events related to reductions in cerebral blood flow and/or oxygen delivery. Even though progress has been achieved over the last 10 years in this field and fascinating new techniques have been developed, it is still not clear which monitor parameter will provide adequate information on the depth of anes thesia and the analgesic level. Because the central nervous system has been one of the main research areas in our department over the last 10 years, we organized a workshop to summarize the latest developments in central nervous system monitoring. This book comprises the topics of this workshop and is intended to provide insight into the current status of central nervous system monitoring, elucidating possible indications and delineating its limitations.

I Monitoring of the Electroencephalogram-Fundamentals

Interactions of Anesthetics at Different Levels of the Central Nervous System
Principles of Central Nervous System Monitoring in Humans
II Techniques and Applications ofElectroencephalogram-Monitoring
Pharmacokinetic and Pharmacodynamic Interactions Relevant To Cerebral Monitoring
Electroencephalographic Feedback Control of Anesthetic Drug Administration
The Use of Processed EEG in the Operating Room
Bispectral Electroencephalogram Analysis for Monitoring Anesthetic Adequacy
Does Spectral Edge Frequency Assess Depth of Anesthesia?
"Paradoxical Arousal" During Isoflurane/Nitrous Oxide Anesthesia: Quantitative Topographical EEG Analysis
Central Nervous System Monitoring; Reduction of Information Content of Quantitative Electroencephalograms for Continuous On-Line Display During Anesthesia
III Monitoring of Stimulus Evoked Responses
Central Evoked Brain Potential as Overall Control of Afferent Systems
Indication for Evoked Potential Monitoring: A Surgical View
Anesthesia and Somatosensory Evoked Responses
Peri-operative Anesthesiological Monitoring of Auditory-Evoked Potentials
The 40-Hz Auditory Steady State Response for Monitoring Level of Consciousness: Methodological Considerations
Motor Evoked Potentials
IV Evoked Response: Special Applications
Auditory Evoked Potentials to Monitor Intra-operative Awareness
Evoked Potential Monitoring for Vascular Surgery
Assessment of Analgesic Drug Treatment
Long-Term Monitoring in Intensive Care Patients: Electroencephalogram, Evoked Responses, and Brain Mapping
V Present and Future Trends in Cerebral Monitoring
Present and Future Trends in Multimodal Cerebral Monitoring in Anesthesia and Intensive Care
Jugular Bulb VenousOxygen Saturation and Transcranial Doppler Ultrasonography in Neurosurgical Patients
Transcranial Doppler Sonography: Monitoring of Cerebral Perfusion
BRAINDEX-An Expert System for Supporting Brain Death Diagnosis.