BACKGROUND: Studies of children who undergo major non-cardiac surgery in the neonatal period are needed so that subsequent abnormal neurodevelopment can be better understood. OBJECTIVE: It was the aim of our study to describe the influence of analgesic and sedative medication on the predominant background pattern and the development of sleep-wake cycling (SWC), as measured on amplitude-integrated electroencephalography (aEEG), in newborn infants born ≥ 32 weeks' gestation after major non-cardiac surgery. METHODS: This prospective study included infants ≥ 32(+0) weeks' gestation admitted to the Neonatal Intensive Care Unit at The Royal Children's Hospital in Melbourne who were undergoing major non-cardiac surgery. Data on morphine and midazolam given after surgery were recorded and the BrainZ Monitor was applied post-operatively. The maximum levels of morphine and midazolam were assessed as predictors of time to aEEG outcomes using linear regression. RESULTS: Forty-seven eligible infants were included. Emergence of SWC was observed at a mean of 13 h after surgery. The maximum dose of morphine or midazolam was not predictive of time to either any or developed SWC. CONCLUSIONS: Despite high doses of morphine and midazolam, SWC was observed on aEEG in neonates ≥ 32 weeks' gestational age soon after major non-cardiac surgery. The aEEG background pattern was not affected by the maximum dose of either morphine or midazolam.
BACKGROUND: Studies of children who undergo major non-cardiac surgery in the neonatal period are needed so that subsequent abnormal neurodevelopment can be better understood. OBJECTIVE: It was the aim of our study to describe the influence of analgesic and sedative medication on the predominant background pattern and the development of sleep-wake cycling (SWC), as measured on amplitude-integrated electroencephalography (aEEG), in newborn infants born ≥ 32 weeks' gestation after major non-cardiac surgery. METHODS: This prospective study included infants ≥ 32(+0) weeks' gestation admitted to the Neonatal Intensive Care Unit at The Royal Children's Hospital in Melbourne who were undergoing major non-cardiac surgery. Data on morphine and midazolam given after surgery were recorded and the BrainZ Monitor was applied post-operatively. The maximum levels of morphine and midazolam were assessed as predictors of time to aEEG outcomes using linear regression. RESULTS: Forty-seven eligible infants were included. Emergence of SWC was observed at a mean of 13 h after surgery. The maximum dose of morphine or midazolam was not predictive of time to either any or developed SWC. CONCLUSIONS: Despite high doses of morphine and midazolam, SWC was observed on aEEG in neonates ≥ 32 weeks' gestational age soon after major non-cardiac surgery. The aEEG background pattern was not affected by the maximum dose of either morphine or midazolam.
Authors: Sarah B Mulkey; Vivien L Yap; Shasha Bai; Raghu H Ramakrishnaiah; Charles M Glasier; Renee A Bornemeier; Michael L Schmitz; Adnan T Bhutta Journal: Pediatr Neurol Date: 2015-03-05 Impact factor: 3.372
Authors: Mirthe J Mebius; Nathalie J E Oostdijk; Sara J Kuik; Arend F Bos; Rolf M F Berger; Caterina M Bilardo; Elisabeth M W Kooi; Hendrik J Ter Horst Journal: Pediatr Res Date: 2018-01-10 Impact factor: 3.756
Authors: Sujith S Pereira; Stephen T Kempley; David F Wertheim; Ajay K Sinha; Joan K Morris; Divyen K Shah Journal: Front Neurol Date: 2018-02-26 Impact factor: 4.003