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A Neurologic Examination for Anesthesiologists: Assessing Arousal Level during Induction, Maintenance, and Emergence.

TitleA Neurologic Examination for Anesthesiologists: Assessing Arousal Level during Induction, Maintenance, and Emergence.
Publication TypeJournal Article
Year of Publication2019
AuthorsReshef ER, Schiff ND, Brown EN
JournalAnesthesiology
Volume130
Issue3
Pagination462-471
Date Published2019 03
ISSN1528-1175
KeywordsAirway Extubation, Anesthesiologists, Anesthetics, Inhalation, Arousal, Electroencephalography, Humans, Neurologic Examination, Postoperative Care
Abstract

Anesthetics have profound effects on the brain and central nervous system. Vital signs, along with the electroencephalogram and electroencephalogram-based indices, are commonly used to assess the brain states of patients receiving general anesthesia and sedation. Important information about the patient's arousal state during general anesthesia can also be obtained through use of the neurologic examination. This article reviews the main components of the neurologic examination focusing primarily on the brainstem examination. It details the components of the brainstem examination that are most relevant for patient management during induction, maintenance, and emergence from general anesthesia. The examination is easy to apply and provides important complementary information about the patient's arousal level that cannot be discerned from vital signs and electroencephalogram measures.

DOI10.1097/ALN.0000000000002559
Alternate JournalAnesthesiology
PubMed ID30664547
Grant ListDP1 OD003646 / OD / NIH HHS / United States
R01 GM104948 / GM / NIGMS NIH HHS / United States

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