NEUROANESTHESIA: Edited by Lingzhong MengDouble standard: why electrocardiogram is standard care while electroencephalogram is not?Li, Yuna,b; Bohringer, Christianb; Liu, HongbAuthor Information aDepartment of Anesthesiology and Perioperative Medicine, The Second Hospital of Anhui Medical University, Hefei, China bDepartment of Anesthesiology and Pain Medicine, University of California Davis Health, Sacramento, California, USA Correspondence to Hong Liu, MD, FASE, Professor, Department of Anesthesiology and Pain Medicine, University of California Davis Health, 4150 V Street, Suite 1200, Sacramento, CA 95817, USA. Tel: +1 916 734 5031; fax: +1 916 734 7980; e-mail: firstname.lastname@example.org Current Opinion in Anaesthesiology: October 2020 - Volume 33 - Issue 5 - p 626-632 doi: 10.1097/ACO.0000000000000902 Buy Metrics Abstract Purpose of review Major adverse cardiovascular and cerebrovascular events (MACCE) significantly affect the surgical outcomes. Electrocardiogram (ECG) has been a standard intraoperative monitor for 30 years. Electroencephalogram (EEG) can provide valuable information about the anesthetized state and guide anesthesia management during surgery. Whether EEG should be a standard intraoperative monitor is discussed in this review. Recent findings Deep anesthesia has been associated with postoperative delirium, especially in elderly patients. Intraoperative EEG monitoring has been demonstrated to reduce total anesthesia drug use during general anesthesia and postoperative delirium. Summary Unlike ECG monitoring, the EEG under general anesthesia has not been designated as a standard monitor by anesthesiologist societies around the world. The processed EEG technology has been commercially available for more than 25 years and EEG technology has significantly facilitated its intraoperative use. It is time to consider EEG as a standard anesthesia monitor during surgery. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.