Intraoperative EEG Monitoring in Pediatric Anesthesia

Purpose of Review: This review summarizes the literature on intraoperative electroencephalography (EEG) monitoring in pediatric anesthesia from 2017 to 2022. Recent Findings: New developments to our understanding of EEG changes in the anesthetized brain, developing brain, emergence delirium, epileptiform activity, and EEG changes during spinal anesthesia will be discussed. Low voltage EEG (i.e., discontinuous or isoelectric EEG) and its association with changes in the alpha frequency (8–12 Hz) band, non-proprietary EEG to guide anesthetic dosing in young children, EEG-guided propofol anesthesia, and a summary of EEG studies to improve clinical outcomes will be covered. Summary: Intraoperative EEG in children has gained significant interest over the past few years. Despite our improved understanding of EEG changes under anesthesia, and using EEG as a biomarker of anesthetic depth to titrate dosing in children, much remains to be discovered, particularly related to the optimal EEG parameters to use in infants and how EEG can be used to improve clinical outcomes.