O Akeju1, K J Pavone2, J A Thum3, P G Firth4, M B Westover5, M Puglia6, E S Shank6, E N Brown7, P L Purdon8. 1. Department of Anesthesia, Critical Care and Pain Medicine Harvard Medical School, Boston, MA, USA oluwaseun.akeju@mgh.harvard.edu patrickp@nmr.mgh.harvard.edu. 2. Department of Anesthesia, Critical Care and Pain Medicine. 3. Harvard Medical School, Boston, MA, USA Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology. 4. Department of Anesthesia, Critical Care and Pain Medicine Department of Neurology, Massachusetts General Hospital, Boston, MA, USA. 5. Department of Neurology, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA. 6. Department of Anesthesia, Critical Care and Pain Medicine Harvard Medical School, Boston, MA, USA. 7. Department of Anesthesia, Critical Care and Pain Medicine Harvard Medical School, Boston, MA, USA Department of Brain and Cognitive Science Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA. 8. Department of Anesthesia, Critical Care and Pain Medicine Harvard Medical School, Boston, MA, USA Department of Brain and Cognitive Science oluwaseun.akeju@mgh.harvard.edu patrickp@nmr.mgh.harvard.edu.
Abstract
BACKGROUND: General anaesthesia induces highly structured oscillations in the electroencephalogram (EEG) in adults, but the anaesthesia-induced EEG in paediatric patients is less understood. Neural circuits undergo structural and functional transformations during development that might be reflected in anaesthesia-induced EEG oscillations. We therefore investigated age-related changes in the EEG during sevoflurane general anaesthesia in paediatric patients. METHODS: We analysed the EEG recorded during routine care of patients between 0 and 28 yr of age (n=54), using power spectral and coherence methods. The power spectrum quantifies the energy in the EEG at each frequency, while the coherence measures the frequency-dependent correlation or synchronization between EEG signals at different scalp locations. We characterized the EEG as a function of age and within 5 age groups: <1 yr old (n=4), 1-6 yr old (n=12), >6-14 yr old (n=14), >14-21 yr old (n=11), >21-28 yr old (n=13). RESULTS: EEG power significantly increased from infancy through ∼6 yr, subsequently declining to a plateau at approximately 21 yr. Alpha (8-13 Hz) coherence, a prominent EEG feature associated with sevoflurane-induced unconsciousness in adults, is absent in patients <1 yr. CONCLUSIONS: Sevoflurane-induced EEG dynamics in children vary significantly as a function of age. These age-related dynamics likely reflect ongoing development within brain circuits that are modulated by sevoflurane. These readily observed paediatric-specific EEG signatures could be used to improve brain state monitoring in children receiving general anaesthesia.
BACKGROUND: General anaesthesia induces highly structured oscillations in the electroencephalogram (EEG) in adults, but the anaesthesia-induced EEG in paediatric patients is less understood. Neural circuits undergo structural and functional transformations during development that might be reflected in anaesthesia-induced EEG oscillations. We therefore investigated age-related changes in the EEG during sevoflurane general anaesthesia in paediatric patients. METHODS: We analysed the EEG recorded during routine care of patients between 0 and 28 yr of age (n=54), using power spectral and coherence methods. The power spectrum quantifies the energy in the EEG at each frequency, while the coherence measures the frequency-dependent correlation or synchronization between EEG signals at different scalp locations. We characterized the EEG as a function of age and within 5 age groups: <1 yr old (n=4), 1-6 yr old (n=12), >6-14 yr old (n=14), >14-21 yr old (n=11), >21-28 yr old (n=13). RESULTS: EEG power significantly increased from infancy through ∼6 yr, subsequently declining to a plateau at approximately 21 yr. Alpha (8-13 Hz) coherence, a prominent EEG feature associated with sevoflurane-induced unconsciousness in adults, is absent in patients <1 yr. CONCLUSIONS:Sevoflurane-induced EEG dynamics in children vary significantly as a function of age. These age-related dynamics likely reflect ongoing development within brain circuits that are modulated by sevoflurane. These readily observed paediatric-specific EEG signatures could be used to improve brain state monitoring in children receiving general anaesthesia.
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