Precision Anesthesia in Modern Surgery: Integrating Neurophysiologic Monitoring and Adaptive Perioperative Control
DOI:
https://doi.org/10.64784/164Palavras-chave:
Adaptive anesthesia, neurophysiologic monitoring, electroencephalography, bispectral index, perioperative care, precision medicine, closed-loop anesthesia, postoperative delirium, cognitive dysfunction, anesthetic depthResumo
Adaptive anesthesia has emerged as a paradigm shift in modern perioperative medicine, integrating neurophysiologic monitoring and individualized anesthetic control to optimize patient outcomes. This review analyzes current evidence on the role of electroencephalographic monitoring, depth-of-anesthesia indices, and closed-loop systems in guiding anesthetic management. A structured analysis of high-impact studies published from 2020 onward was conducted, focusing on neurophysiological mechanisms, perioperative outcomes, and technological advancements. The findings demonstrate that EEG-based monitoring improves the accuracy of anesthetic depth assessment and allows for more precise titration of anesthetic agents. Excessive anesthetic depth was consistently associated with higher rates of postoperative delirium, cognitive dysfunction, and hemodynamic instability, while adaptive strategies contributed to improved intraoperative stability and recovery profiles. Closed-loop systems showed potential in reducing variability and enhancing anesthetic precision, although their implementation remains limited. From an international perspective, the adoption of adaptive anesthesia is increasing, including in Latin American contexts such as Mexico, Colombia, and Ecuador, despite existing disparities in resources and training. Overall, adaptive anesthesia represents a transition toward precision-based, patient-centered perioperative care. Further research is required to standardize protocols, validate emerging technologies, and ensure broader clinical applicability.
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