{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:46:23Z","timestamp":1792061183665,"version":"4.4.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Electroencephalography (EEG) monitoring during pediatric anesthesia may improve perioperative safety by optimizing anesthetic titration and reducing adverse outcomes. However, little is known about patient and caregiver perceptions regarding this technology and its implementation into routine anesthesia care.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n This study evaluates perceived importance, utility, and extent of reassurance provided by intra\u2010operative EEG monitoring among pediatric patients and their parents. Secondary aims include identifying concerns surrounding general anesthesia (GA), concerns surrounding EEG monitoring, cost and willingness to pay, and sociodemographic and medical factors shaping these attitudes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted an exploratory cross\u2010sectional survey at a tertiary pediatric hospital in Singapore between July 2022 and September 2025. Respondents were parents of children aged 1\u201318\u2009years and children aged 12\u201318 scheduled for elective procedures under general anesthesia. A 16\u2010item anonymized questionnaire assessed perceptions of intra\u2010operative EEG monitoring, concerns about anesthesia, and attitudes regarding the cost of EEG monitoring.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 400 respondents (100 children, 300 parents), 83.5% rated intra\u2010operative brain monitoring as \u201cvery\u201d or \u201cquite\u201d important and 93% reported feeling more reassured by its use. Children were most concerned about intraoperative awareness and failure to awaken, whereas parents were most concerned about anesthetic side effects and dosage. Parents with higher education and whose children had prior anesthetic exposure reported greater reassurance from EEG monitoring. Cost was the leading concern regarding EEG monitoring, particularly among parents from families residing in public housing. Despite this, most parents (75%) and children (59%) expressed willingness to pay for EEG monitoring.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Pediatric patients and parents viewed intra\u2010operative EEG monitoring as important and reassuring, and expressed willingness to support its implementation despite cost concerns. These findings suggest that families are unlikely to be a major barrier to EEG adoption and highlight the need for clinician\u2010 and system\u2010level strategies to integrate EEG monitoring into family\u2010centered pediatric anesthesia care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/pan.70329","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:03:41Z","timestamp":1792058621000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceptions of Intra\u2010Operative\n EEG<\/scp>\n Brain Monitoring During Pediatric Anesthesia Among Children and Parents: An Exploratory Cross\u2010Sectional Survey"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5881-360X","authenticated-orcid":false,"given":"Kah Hau Luke","family":"Chua","sequence":"first","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7410-4767","authenticated-orcid":false,"given":"Teddy","family":"Fabila","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesia KK Women's and Children's Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neyziel","family":"Mardo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesia KK Women's and Children's Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0173-7517","authenticated-orcid":false,"given":"Choon Looi","family":"Bong","sequence":"additional","affiliation":[{"name":"Department of Pediatric Anesthesia KK Women's and Children's Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1007\/s12630-015-0490-0","article-title":"Anesthetic Depth and Long\u2010Term Survival: An Update","volume":"63","author":"Leslie K.","year":"2016","journal-title":"Canadian Journal of Anaesthesia"},{"key":"e_1_2_9_3_1","article-title":"Bispectral Index for Improving Anesthetic Delivery and Postoperative Recovery","volume":"6","author":"Punjasawadwong Y.","year":"2014","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"1","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1213\/ANE.0000000000006267","article-title":"A Narrative Review Illustrating the Clinical Utility of Electroencephalogram\u2010Guided Anesthesia Care in Children","volume":"137","author":"Bong C. L.","year":"2023","journal-title":"Anesthesia and Analgesia"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinane.2022.110913","article-title":"Sevoflurane Requirements During Electroencephalogram (EEG)\u2010Guided vs Standard Anesthesia Care in Children: A Randomized Controlled Trial","volume":"81","author":"Long M. H. Y.","year":"2022","journal-title":"Journal of Clinical Anesthesia"},{"issue":"7","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1001\/jamapediatrics.2025.0517","article-title":"EEG\u2010Guided Titration of Sevoflurane and Pediatric Anesthesia Emergence Delirium: A Randomized Clinical Trial","volume":"179","author":"Miyasaka K. W.","year":"2025","journal-title":"JAMA Pediatrics"},{"issue":"6","key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1016\/j.bja.2021.02.016","article-title":"Morbidity and Mortality After Anesthesia in Early Life: Results of the European NECTARINE Study","volume":"126","author":"Disma N.","year":"2021","journal-title":"British Journal of Anaesthesia"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1213\/ANE.0000000000007230","article-title":"The Utility of Electroencephalograhy in Guiding General Anesthesia in Children","volume":"142","author":"Bong C. L.","year":"2024","journal-title":"Anesthesia and Analgesia"},{"issue":"1","key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12911-023-02118-2","article-title":"Public Attitudes Towards the Use of Novel Technologies in Their Future Healthcare: A UK Survey","volume":"23","author":"Sauchelli S.","year":"2023","journal-title":"BMC Medical Informatics and Decision Making"},{"issue":"9","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1111\/j.1460-9592.2006.01904.x","article-title":"Risk Factors for Anxiety at Induction of Anesthesia in Children: A Prospective Cohort Study","volume":"16","author":"Davidson A. J.","year":"2006","journal-title":"Paediatric Anaesthesia"},{"issue":"17","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12175527","article-title":"The Impact of Parental Presence on Invasive Procedures in the Pediatric Emergency Department: A Prospective Study","volume":"12","author":"Hashavya S.","year":"2023","journal-title":"Journal of Clinical Medicine"},{"issue":"1","key":"e_1_2_9_12_1","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/anae.14465","article-title":"Parental Perception on the Effects of Early Exposure to Anaesthesia on Neurodevelopment","volume":"74","author":"Koh J. H.","year":"2019","journal-title":"Anaesthesia"},{"issue":"1","key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The Qualitative Content Analysis Process","volume":"62","author":"Elo S.","year":"2008","journal-title":"Journal of Advanced Nursing"},{"issue":"10","key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1007\/s11606-021-06737-1","article-title":"A Consensus\u2010Based Checklist for Reporting of Survey Studies (CROSS)","volume":"36","author":"Sharma A.","year":"2021","journal-title":"Journal of General Internal Medicine"},{"issue":"6","key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1097\/ACO.0000000000001186","article-title":"Preoperative Anxiety","volume":"35","author":"Friedrich S.","year":"2022","journal-title":"Current Opinion in Anaesthesiology"},{"issue":"9","key":"e_1_2_9_16_1","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1111\/pan.13931","article-title":"I'm Afraid! Children's Experiences of Being Anesthetized","volume":"30","author":"Andersson L.","year":"2020","journal-title":"Paediatric Anaesthesia"},{"key":"e_1_2_9_17_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.pec.2023.107674","article-title":"Kids Voices, the Perioperative Experience of Emergency Surgery From Children's Perspectives: A Qualitative Study","volume":"110","author":"Heath C.","year":"2023","journal-title":"Patient Education and Counseling"},{"issue":"3","key":"e_1_2_9_18_1","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.ejon.2014.01.006","article-title":"Children's Participation in Shared Decision\u2010Making: Children, Adolescents, Parents and Healthcare Professionals' Perspectives and Experiences","volume":"18","author":"Coyne I.","year":"2014","journal-title":"European Journal of Oncology Nursing"},{"issue":"4","key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/cch.12197","article-title":"Involving Disabled Children and Young People as Partners in Research: A Systematic Review","volume":"41","author":"Bailey S.","year":"2015","journal-title":"Child: Care, Health and Development"},{"issue":"10","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.12968\/hmed.2014.75.10.573","article-title":"Awareness Under General Anesthesia","volume":"75","author":"Rule E.","year":"2014","journal-title":"British Journal of Hospital Medicine"},{"key":"e_1_2_9_21_1","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-12-80","article-title":"Health Literacy and Public Health: A Systematic Review and Integration of Definitions and Models","volume":"12","author":"S\u00f8rensen K.","year":"2012","journal-title":"BMC Public Health"},{"issue":"2","key":"e_1_2_9_22_1","first-page":"547","article-title":"Assessing Patients' Knowledge and Attitude Toward Anesthesia and Its Complications in a Tertiary Center: An Original Study","volume":"10","author":"Koohsari P.","year":"2024","journal-title":"Archives of Anesthesiology and Critical Care"},{"issue":"3","key":"e_1_2_9_23_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1097\/WNP.0000000000001099","article-title":"Survey of Continuous EEG Monitoring Practices in the United States","volume":"42","author":"Kayal G.","year":"2025","journal-title":"Journal of Clinical Neurophysiology"},{"issue":"5","key":"e_1_2_9_24_1","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1097\/ACO.0000000000001521","article-title":"Advancing Electroencephalography Education in Anesthesiology","volume":"38","author":"Berger\u2010Estilita J.","year":"2025","journal-title":"Current Opinion in Anaesthesiology"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70329","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pan.70329","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70329","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T10:03:45Z","timestamp":1792058625000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pan.70329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":23,"alternative-id":["10.1002\/pan.70329"],"URL":"https:\/\/doi.org\/10.1002\/pan.70329","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"2026-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pan.70329"}}