• Edith R Reshef, Nicholas D Schiff, and Emery N Brown.
• From the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts (E.R.R.) the Feil Family Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, New York, New York (N.D.S.) the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (E.N.B) the Department of Brain and Cognitive Science, the Institute for Medical Engineering and Sciences, the Picower Institute for Learning and Memory, and the Institute for Data, Systems and Society, Massachusetts Institute of Technology, Cambridge, Massachusetts (E.N.B).
• Anesthesiology. 2019 Mar 1; 130 (3): 462-471.

AbstractAnesthetics 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.

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