Effectiveness of Electroencephalography Guided Anesthesia

• EEG-guided anesthesia training program for anesthesia providers (Other): The EEG-guided anesthesia training session for the anesthesia providers will administer simulation-based assessments at baseline, immediately post-intervention, and at one, three, and six month follow-up time points to track provider competency in EEG interpretation and anesthetic titration.
• EEG-Guided Intervention (Device): All surgical patients in Part B of the study will receive EEG-guided anesthesia. EEG data collected from patient participants will be provided as live data during their surgical procedures to the anesthesia provider. Anesthesia providers may use this data to assist their decision-making on anesthetic delivery.

Primary outcomes

• Minimum Alveolar Concentration (MAC) [Intra-operative phase of care of participant.]: The primary endpoint is the total intraoperative anesthetic exposure. This will be measured as the time-weighted average of the age-adjusted Minimum Alveolar Concentration (MAC) of volatile anesthetic administered during the maintenance phase of anesthesia. These data will be collected directly from the electronic anesthetic record for each enrolled patient case and will be reviewed and verified by the study team.

Secondary outcomes

• 3-Minute Diagnostic Confusion Assessment Method (3D-CAM) [Postoperative Days 1 to 3.]: To gather data for POD progression modeling, patients will be assessed for delirium daily for the first three postoperative days using the 3-Minute Diagnostic Confusion Assessment Method (3D-CAM). These assessments will be performed by trained research staff who are blinded to the patient's treatment group.

Sex: All, ages: 18 Years to any, accepts healthy volunteers

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.