Effectiveness of Electroencephalography Guided Anesthesia

Inclusion criteria

Part A Inclusion Criteria:

• Signed and dated informed consent form prior to any study-specific procedures.
• Willingness and ability to comply with all study procedures and availability for the duration of the study, including all scheduled assessments and follow-up visits.
• Currently practicing anesthetic provider, defined as either:

• Attending anesthesiologist, or
• Certified Registered Nurse Anesthetist (CRNA).
• Limited prior formal training in EEG interpretation for anesthetic depth, as self-reported by the participant (see Exclusion Criteria for details).
• Fluent in English, to ensure comprehension of study materials and assessments.
• Able to access and utilize required technology (e.g., computer or tablet with internet access) for completion of digital modules and online assessments.
• In good general health and capable of fulfilling clinical duties, as self-reported and confirmed by site investigator review.
• Willingness to be randomized to any of the study arms and to participate in all assigned educational interventions and assessments.
• Willingness to adhere to the protocol-specified anesthetic management strategy during the real-case assessments.

Part B Inclusion Criteria:

• Provides written, signed informed consent prior to the surgical procedure.
• Is age 60 years or older.
• Is scheduled to undergo an elective, non-cardiac, non-neurologic surgical procedure expected to last at least two hours.
• Is planned to receive general anesthesia.
• Has an American Society of Anesthesiologists (ASA) physical status of I, II, or III.
• Has intact skin on the forehead suitable for the application of EEG electrodes.

Exclusion criteria

Part A Exclusion Criteria:

• Fellowship training in neuroanesthesia or neurocritical care.
• Participation in EEG-related research or formal EEG training within the past 12 months.
• Inability to access or utilize required technology (e.g., computer or tablet with internet access) necessary for completion of digital modules and online assessments.
• Any condition (physical, psychological, or cognitive) that, in the opinion of the site investigator, would preclude full participation in study activities or completion of the study protocol.
• Known allergy or sensitivity to materials used in EEG electrodes (e.g., adhesives or gels), if applicable.
• Non-practicing anesthetic providers (e.g., retired, not currently providing clinical care).

Part B Exclusion Criteria:

• Is unable to provide legally effective informed consent.
• Is scheduled for emergency, cardiac, or neurologic surgery.
• Has an American Society of Anesthesiologists (ASA) physical status of IV or greater.
• Has a pre-existing diagnosis of dementia, significant cognitive impairment, or other major neurologic disease (e.g., epilepsy, Parkinson's disease).
• Has a known allergy to the adhesives or gels used with EEG electrodes.
• Has a condition, such as a craniofacial deformity or skin condition on the forehead, that would prevent proper placement or functioning of the EEG monitor.
• Currently pregnant.