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Br J Anaesth. 2015 Jul;115 Suppl 1:i66-i76. doi: 10.1093/bja/aev114.

Age-dependency of sevoflurane-induced electroencephalogram dynamics in children.

Author information

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.

KEYWORDS:

electroencephalography; pediatric; sevoflurane

PMID:
26174303
PMCID:
PMC4501917
DOI:
10.1093/bja/aev114
[Indexed for MEDLINE]
Free PMC Article

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