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Advancing Trends in Electroencephalography Monitoring in Anesthesia: A Bibliometric Analysis from 1980 to 2024

Year 2025, Volume: 7 Issue: 3, 442 - 452, 13.10.2025
https://doi.org/10.52827/hititmedj.1654866

Abstract

This study examines research trends, productivity, and global academic collaborations related to electroencephalography (EEG) monitoring in anesthesia management. Articles published between 1980 and 2024 were analyzed using bibliometric methods in the Web of Science database.
A total of 3,371 articles were identified, with anesthesiology, neuroscience, and clinical neurology being the most active areas. The United States (865 articles) and Germany (433 articles) were the leading contributors. The number of articles strongly correlated with economic indicators such as Gross Domestic Product-Purchasing Power Parity (GDP-PPP) (r=0.885, p<0.001). EEG monitoring has become a multidisciplinary field with high citation rates in anesthesiology and neuroscience journals.
Key research topics include the bispectral index (BIS), Narcotrend index, entropy-based EEG analyses, and personalized anesthesia management. Developed countries drive innovation in this field, while equipment costs, technological requirements, and data interpretation complexity remain major barriers to widespread adoption of EEG-based anesthesia monitoring.

References

  • Sun Y, Wei C, Cui V, Xiu M, Wu A. Electroencephalography: Clinical applications during the perioperative period. Front Med (Lausanne) 2020;7:251.
  • Laferrière-Langlois P, Morisson L, Jeffries S, Duclos C, Espitalier F, Richebé P. Depth of anesthesia and nociception monitoring: current state and vision for 2050. Anesth Analg 2024;138(2):295-307.
  • Bouchez S, Fraipont V, Momeni M, Rex S, De Hert S. Perioperative hemodynamic monitoring techniques: a narrative review. Acta Anaesthesiologica Belgica 2024;75:125-138.
  • Montupil J, Defresne A, Bonhomme V. The raw and processed electroencephalogram as a monitoring and diagnostic tool. J Cardiothorac Vasc Anesth 2019;33 Suppl 1:s3-10.
  • Bonatti G, Iannuzzi F, Amodio S, et al. Neuromonitoring during general anesthesia in non-neurologic surgery. Best Pract Res Clin Anaesthesiol 2021;35(2):255-266.
  • Fleischmann A, Georgii MT, Schuessler J, Schneider G, Pilge S, Kreuzer M. Always assess the raw electroencephalogram: why automated burst suppression detection may not detect all episodes. Anesth Analg 2023;136(2):346-354.
  • Fahy BG, Chau DF. The technology of processed electroencephalogram monitoring devices for assessment of depth of anesthesia. Anesth Analg 2018;126(1):111-117.
  • Shander A, Lobel GP, Mathews DM. Brain monitoring and the depth of anesthesia: another goldilocks dilemma. Anesth Analg 2018;126(2):705-709.
  • Roche D, Mahon P. Depth of anesthesia monitoring. Anesthesiol Clin. 2021;39(3):477-492.
  • Khoo HM, Hall JA, Dubeau F, et al. Technical aspects of SEEG and its interpretation in the delineation of the epileptogenic zone. Neurol Med Chir (Tokyo) 2020;60(12):565-580.
  • Domingo RA, Vivas-Buitrago T, De Biase G, et al. Intraoperative seizure detection during active resection of glioblastoma through a novel hollow circular electrocorticography array. Oper Neurosurg (Hagerstown) 2021;21(2):e147-152.
  • Larkin CM, O’Brien DF, Maheshwari D. Anaesthesia for epilepsy surgery. BJA Education 2019;19(12):383-389.
  • Myles PS, Leslie K, McNeil J, Forbes A, Chan MT. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. Lancet 2004;363(9423):1757-1763.
  • Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. N Engl J Med 2008;358(11):1097-1108.
  • Purdon PL, Pierce ET, Mukamel EA, et al. Electroencephalogram signatures of loss and recovery of consciousness from propofol. Proc Natl Acad Sci USA 2013;110(12):E1142-1151.
  • Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology 1997;87(4):808-815.
  • Smith WD, Dutton RC, Smith NT. Measuring the performance of anesthetic depth indicators. Anesthesiology 1996;84(1):38-51.
  • Liu J, Singh H, White PF. Electroencephalographic bispectral index correlates with intraoperative recall and depth of propofol-induced sedation. Anesth Analg 1997;84(1):185-189.
  • Sessler DI, Sigl JC, Kelley SD, et al. Hospital stay and mortality are increased in patients having a “triple low” of low blood pressure, low bispectral index, and low minimum alveolar concentration of volatile anesthesia. Anesthesiology 2012;116(6):1195-1203.
  • Sebel PS, Lang E, Rampil IJ, et al. A multicenter study of bispectral electroencephalogram analysis for monitoring anesthetic effect. Anesth Analg 1997;84(4):891-899.
  • Murphy M, Bruno MA, Riedner BA, et al. Propofol anesthesia and sleep: a high-density EEG study. Sleep 2011;34(3):283-291A.
  • Song D, Joshi GP, White PF. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology 1997;87(4):842-848.
  • Bruhn J, Röpcke H, Hoeft A. Approximate entropy as an electroencephalographic measure of anesthetic drug effect during desflurane anesthesia. Anesthesiology 2000;92(3):715-726.
  • Steriade M, Amzica F, Contreras D. Cortical and thalamic cellular correlates of electroencephalographic burst-suppression. Electroencephalogr Clin Neurophysiol 1994;90(1):1-16.
  • Katoh T, Suzuki A, Ikeda K. Electroencephalographic derivatives as a tool for predicting the depth of sedation and anesthesia induced by sevoflurane. Anesthesiology 1998;88(3):642-650.
  • Scott JC, Cooke JE, Stanski DR. Electroencephalographic quantitation of opioid effect: comparative pharmacodynamics of fentanyl and sufentanil. Anesthesiology 1991;74(1):34-42.
  • Purdon PL, Pavone KJ, Akeju O, et al. The Ageing Brain: Age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia. Br J Anaesth 2015;115 Suppl 1:i46-57.
  • Rampil IJ. A primer for EEG signal processing in anesthesia. Anesthesiology 1998;89(4):980-1002.
  • Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiology 1997;86(4):836-847.
  • Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical electroencephalography for anesthesiologists: part ı: background and basic signatures. Anesthesiology 2015;123(4):937-960.
  • Sigl JC, Chamoun NG. An introduction to bispectral analysis for the electroencephalogram. J Clin Monit 1994;10(6):392-404.
  • Johansen JW, Sebel PS. Development and clinical application of electroencephalographic bispectrum monitoring. Anesthesiology 2000;93(5):1336-1344.
  • Brown EN, Lydic R, Schiff ND. General anesthesia, sleep, and coma. N Engl J Med 2010;363(27):2638-2650.
  • Vacas S, Hudson AE. Seen and ignored: are we undermining studies of brain health ınterventions before we start? Anesth Analg 2020;131(2):464-465.
  • Chen N, Lu J. Meta-analysis of the prognostic value of narcotrend monitoring of different depths of anesthesia and different bispectral ındex (bıs) values for cognitive dysfunction after tumor surgery in elderly patients. J Healthc Eng 2022;2022:8554188.
  • Ma X, Zhao X, Guo R, Hu Z, Liu J, Nie H. Value of narcotrend anesthesia depth monitoring in predicting POCD in gastrointestinal tumor anesthesia block patients. BMC Anesthesiol 2024;24(1):371.
  • De Heer IJ, Raab HAC, Krul S, Karaöz-Bulut G, Stolker RJ, Weber F. Electroencephalographic density spectral array monitoring during propofol/sevoflurane coadministration in children, an exploratory observational study. Anaesth Crit Care Pain Med 2024;43(2):101342.
  • Kayir S, Kisa A. The evolution of the regional anesthesia: a holistic investigation of global outputs with bibliometric analysis between 1980-2019. Korean J Pain 2021;34(1):82-93.
  • Asefzadeh S, Jahandideh S, Mousavi A. Relationship between Human Development Index and the number of scientific articles of countries. JQUMS 2013;17(2):33-40.
  • Zhang Y, Yan F, Wang Q, Wang Y, Huang L. Pre-anesthetic brain network metrics as predictors of individual propofol sensitivity. Comput Methods Programs Biomed 2024;257:108447.
  • Liang Z, Lan Z, Wang Y, et al. The EEG complexity, information integration and brain network changes in minimally conscious state patients during general anesthesia. J Neural Eng. 2023;20(6):066030.
  • Romagnoli S, Franchi F, Ricci Z. Processed EEG monitoring for anesthesia and intensive care practice. Minerva Anestesiol 2019;85(11):1219-1230.
  • Oliva AM, Montejano J, Simmons CG, Vogel SA, Isaza CF, Clavijo CF. New frontiers in intraoperative neurophysiologic monitoring: a narrative review. Ann Transl Med 2023;11(11):388.
  • Manohara N, Ferrari A, Greenblatt A, et al. Electroencephalogram monitoring during anesthesia and critical care: a guide for the clinician. J Clin Monit Comput 2025;39(2):315-348.

Anestezide Elektroensefalografi Monitörizasyonunda Gelişen Trendler: 1980'den 2024'e Bibliyometrik Analiz

Year 2025, Volume: 7 Issue: 3, 442 - 452, 13.10.2025
https://doi.org/10.52827/hititmedj.1654866

Abstract

Bu çalışma, anestezi yönetiminde elektroensefalografi (EEG) monitörizasyonu ile ilgili araştırma eğilimlerini, üretkenliği ve küresel akademik iş birliklerini incelemektedir. 1980-2024 yılları arasında yayımlanan makaleler, Web of Science veritabanında bibliyometrik analiz yöntemiyle değerlendirilmiştir.
Toplam 3.371 makale tespit edilmiş olup en aktif araştırma alanları anesteziyoloji, sinir bilimleri ve klinik nörolojidir. ABD (865 makale) ve Almanya (433 makale) en fazla katkı sağlayan ülkeler olarak öne çıkmıştır. Makale sayısı, Gayri Safi Yurtiçi Hasıla-Satın Alma Gücü Paritesi (GDP-PPP) gibi ekonomik göstergelerle güçlü bir ilişki göstermiştir (r=0.885, p<0.001). EEG izlemi, anesteziyoloji ve sinir bilimi dergilerinde yüksek atıf oranlarıyla çok disiplinli bir alan olarak öne çıkmaktadır.
Öne çıkan araştırma konuları arasında Bispektral indeks (BIS), Narcotrend indeksi, entropi temelli EEG analizleri ve EEG verilerine dayalı kişiselleştirilmiş anestezi yönetimi yer almaktadır. Gelişmiş ülkeler bu alanda yeniliklerin öncüsü konumundadır. Ancak ekipman maliyetleri, teknolojik gereksinimler ve veri yorumlamanın karmaşıklığı, EEG tabanlı anestezi izleminin yaygınlaşmasını kısıtlayan temel engeller arasında yer almaktadır.

References

  • Sun Y, Wei C, Cui V, Xiu M, Wu A. Electroencephalography: Clinical applications during the perioperative period. Front Med (Lausanne) 2020;7:251.
  • Laferrière-Langlois P, Morisson L, Jeffries S, Duclos C, Espitalier F, Richebé P. Depth of anesthesia and nociception monitoring: current state and vision for 2050. Anesth Analg 2024;138(2):295-307.
  • Bouchez S, Fraipont V, Momeni M, Rex S, De Hert S. Perioperative hemodynamic monitoring techniques: a narrative review. Acta Anaesthesiologica Belgica 2024;75:125-138.
  • Montupil J, Defresne A, Bonhomme V. The raw and processed electroencephalogram as a monitoring and diagnostic tool. J Cardiothorac Vasc Anesth 2019;33 Suppl 1:s3-10.
  • Bonatti G, Iannuzzi F, Amodio S, et al. Neuromonitoring during general anesthesia in non-neurologic surgery. Best Pract Res Clin Anaesthesiol 2021;35(2):255-266.
  • Fleischmann A, Georgii MT, Schuessler J, Schneider G, Pilge S, Kreuzer M. Always assess the raw electroencephalogram: why automated burst suppression detection may not detect all episodes. Anesth Analg 2023;136(2):346-354.
  • Fahy BG, Chau DF. The technology of processed electroencephalogram monitoring devices for assessment of depth of anesthesia. Anesth Analg 2018;126(1):111-117.
  • Shander A, Lobel GP, Mathews DM. Brain monitoring and the depth of anesthesia: another goldilocks dilemma. Anesth Analg 2018;126(2):705-709.
  • Roche D, Mahon P. Depth of anesthesia monitoring. Anesthesiol Clin. 2021;39(3):477-492.
  • Khoo HM, Hall JA, Dubeau F, et al. Technical aspects of SEEG and its interpretation in the delineation of the epileptogenic zone. Neurol Med Chir (Tokyo) 2020;60(12):565-580.
  • Domingo RA, Vivas-Buitrago T, De Biase G, et al. Intraoperative seizure detection during active resection of glioblastoma through a novel hollow circular electrocorticography array. Oper Neurosurg (Hagerstown) 2021;21(2):e147-152.
  • Larkin CM, O’Brien DF, Maheshwari D. Anaesthesia for epilepsy surgery. BJA Education 2019;19(12):383-389.
  • Myles PS, Leslie K, McNeil J, Forbes A, Chan MT. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. Lancet 2004;363(9423):1757-1763.
  • Avidan MS, Zhang L, Burnside BA, et al. Anesthesia awareness and the bispectral index. N Engl J Med 2008;358(11):1097-1108.
  • Purdon PL, Pierce ET, Mukamel EA, et al. Electroencephalogram signatures of loss and recovery of consciousness from propofol. Proc Natl Acad Sci USA 2013;110(12):E1142-1151.
  • Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology 1997;87(4):808-815.
  • Smith WD, Dutton RC, Smith NT. Measuring the performance of anesthetic depth indicators. Anesthesiology 1996;84(1):38-51.
  • Liu J, Singh H, White PF. Electroencephalographic bispectral index correlates with intraoperative recall and depth of propofol-induced sedation. Anesth Analg 1997;84(1):185-189.
  • Sessler DI, Sigl JC, Kelley SD, et al. Hospital stay and mortality are increased in patients having a “triple low” of low blood pressure, low bispectral index, and low minimum alveolar concentration of volatile anesthesia. Anesthesiology 2012;116(6):1195-1203.
  • Sebel PS, Lang E, Rampil IJ, et al. A multicenter study of bispectral electroencephalogram analysis for monitoring anesthetic effect. Anesth Analg 1997;84(4):891-899.
  • Murphy M, Bruno MA, Riedner BA, et al. Propofol anesthesia and sleep: a high-density EEG study. Sleep 2011;34(3):283-291A.
  • Song D, Joshi GP, White PF. Titration of volatile anesthetics using bispectral index facilitates recovery after ambulatory anesthesia. Anesthesiology 1997;87(4):842-848.
  • Bruhn J, Röpcke H, Hoeft A. Approximate entropy as an electroencephalographic measure of anesthetic drug effect during desflurane anesthesia. Anesthesiology 2000;92(3):715-726.
  • Steriade M, Amzica F, Contreras D. Cortical and thalamic cellular correlates of electroencephalographic burst-suppression. Electroencephalogr Clin Neurophysiol 1994;90(1):1-16.
  • Katoh T, Suzuki A, Ikeda K. Electroencephalographic derivatives as a tool for predicting the depth of sedation and anesthesia induced by sevoflurane. Anesthesiology 1998;88(3):642-650.
  • Scott JC, Cooke JE, Stanski DR. Electroencephalographic quantitation of opioid effect: comparative pharmacodynamics of fentanyl and sufentanil. Anesthesiology 1991;74(1):34-42.
  • Purdon PL, Pavone KJ, Akeju O, et al. The Ageing Brain: Age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia. Br J Anaesth 2015;115 Suppl 1:i46-57.
  • Rampil IJ. A primer for EEG signal processing in anesthesia. Anesthesiology 1998;89(4):980-1002.
  • Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiology 1997;86(4):836-847.
  • Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical electroencephalography for anesthesiologists: part ı: background and basic signatures. Anesthesiology 2015;123(4):937-960.
  • Sigl JC, Chamoun NG. An introduction to bispectral analysis for the electroencephalogram. J Clin Monit 1994;10(6):392-404.
  • Johansen JW, Sebel PS. Development and clinical application of electroencephalographic bispectrum monitoring. Anesthesiology 2000;93(5):1336-1344.
  • Brown EN, Lydic R, Schiff ND. General anesthesia, sleep, and coma. N Engl J Med 2010;363(27):2638-2650.
  • Vacas S, Hudson AE. Seen and ignored: are we undermining studies of brain health ınterventions before we start? Anesth Analg 2020;131(2):464-465.
  • Chen N, Lu J. Meta-analysis of the prognostic value of narcotrend monitoring of different depths of anesthesia and different bispectral ındex (bıs) values for cognitive dysfunction after tumor surgery in elderly patients. J Healthc Eng 2022;2022:8554188.
  • Ma X, Zhao X, Guo R, Hu Z, Liu J, Nie H. Value of narcotrend anesthesia depth monitoring in predicting POCD in gastrointestinal tumor anesthesia block patients. BMC Anesthesiol 2024;24(1):371.
  • De Heer IJ, Raab HAC, Krul S, Karaöz-Bulut G, Stolker RJ, Weber F. Electroencephalographic density spectral array monitoring during propofol/sevoflurane coadministration in children, an exploratory observational study. Anaesth Crit Care Pain Med 2024;43(2):101342.
  • Kayir S, Kisa A. The evolution of the regional anesthesia: a holistic investigation of global outputs with bibliometric analysis between 1980-2019. Korean J Pain 2021;34(1):82-93.
  • Asefzadeh S, Jahandideh S, Mousavi A. Relationship between Human Development Index and the number of scientific articles of countries. JQUMS 2013;17(2):33-40.
  • Zhang Y, Yan F, Wang Q, Wang Y, Huang L. Pre-anesthetic brain network metrics as predictors of individual propofol sensitivity. Comput Methods Programs Biomed 2024;257:108447.
  • Liang Z, Lan Z, Wang Y, et al. The EEG complexity, information integration and brain network changes in minimally conscious state patients during general anesthesia. J Neural Eng. 2023;20(6):066030.
  • Romagnoli S, Franchi F, Ricci Z. Processed EEG monitoring for anesthesia and intensive care practice. Minerva Anestesiol 2019;85(11):1219-1230.
  • Oliva AM, Montejano J, Simmons CG, Vogel SA, Isaza CF, Clavijo CF. New frontiers in intraoperative neurophysiologic monitoring: a narrative review. Ann Transl Med 2023;11(11):388.
  • Manohara N, Ferrari A, Greenblatt A, et al. Electroencephalogram monitoring during anesthesia and critical care: a guide for the clinician. J Clin Monit Comput 2025;39(2):315-348.
There are 44 citations in total.

Details

Primary Language English
Subjects Anaesthesiology
Journal Section Review
Authors

Bülent Meriç Çam 0009-0005-1531-6379

Ahmet Salih Tüzen 0000-0001-9040-2262

Mürsel Kahveci 0000-0002-5661-5771

Muhammet Aydın Akdoğan 0000-0002-3862-9221

Publication Date October 13, 2025
Submission Date March 11, 2025
Acceptance Date July 3, 2025
Published in Issue Year 2025 Volume: 7 Issue: 3

Cite

AMA Çam BM, Tüzen AS, Kahveci M, Akdoğan MA. Advancing Trends in Electroencephalography Monitoring in Anesthesia: A Bibliometric Analysis from 1980 to 2024. Hitit Medical Journal. October 2025;7(3):442-452. doi:10.52827/hititmedj.1654866