Anesthetic-specific electroencephalographic patterns during emergence from sevoflurane and isoflurane in infants and children

Document Type

Article

Publication Date

12-1-2009

Abstract

Background: Devices that monitor the depth of anesthesia are increasingly used to titrate sedation and avoid awareness during anesthesia. Many of these monitors are based upon electroencephalography (EEG) collected from large adult reference populations and not pediatric populations (Anesthesiology, 86, 1997, 836; Journal of Anaesthesia, 92, 2004, 393; Anesthesiology, 99, 2003, 34). We hypothesized that EEG patterns in children would be different from those previously reported in adults and that they would show anesthetic-specific characteristics. Methods: This prospective observational study was approved by the Institutional Review Board, and informed written consent was obtained. Patients were randomized to receive maintenance anesthesia with isoflurane or sevoflurane. EEG data collection included at least 10 min at steady-state maintenance anesthesia. The EEG was recorded continuously through emergence until after extubation. A mixed model procedure was performed on global and regional power by pooled data analysis and by analyzing each anesthetic group separately. Statistical significance was defined as P < 0.05. Results: Thirty-seven children completed the study (ages 22 days-3.6 years). Isoflurane and sevoflurane had different effects on global and regional EEG power during emergence from anesthesia, and frontal predominance patterns were significantly different between these two anesthetic agents. Conclusions: The principal finding of the present study was that there are anesthetic-specific and concentration-dependent EEG effects in children. Depth-of-anesthesia monitors that utilize algorithms based on the EEGs of adult reference populations therefore may not be appropriate for use in children. © 2009 Blackwell Publishing Ltd.

Identifier

70450196059 (Scopus)

Publication Title

Paediatric Anaesthesia

External Full Text Location

https://doi.org/10.1111/j.1460-9592.2009.03128.x

e-ISSN

14609592

ISSN

11555645

PubMed ID

19708912

First Page

1157

Last Page

1165

Issue

12

Volume

19

Grant

T32GM008464

Fund Ref

National Institute of General Medical Sciences

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