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EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery

Objective: To compare the EEG changes in vegetative state (VS) patients and non-craniotomy, non-vegetative state (NVS) patients during general anesthesia with low-dose propofol and to find whether it affects the arousal rate of VS patients. Methods: Seven vegetative state patients (VS group: five wi...

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Autores principales: Qin, Xuewei, Chen, Xuanling, Wang, Bo, Zhao, Xin, Tang, Yi, Yao, Lan, Liang, Zhenhu, He, Jianghong, Li, Xiaoli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669685/
https://www.ncbi.nlm.nih.gov/pubmed/38002567
http://dx.doi.org/10.3390/brainsci13111608
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author Qin, Xuewei
Chen, Xuanling
Wang, Bo
Zhao, Xin
Tang, Yi
Yao, Lan
Liang, Zhenhu
He, Jianghong
Li, Xiaoli
author_facet Qin, Xuewei
Chen, Xuanling
Wang, Bo
Zhao, Xin
Tang, Yi
Yao, Lan
Liang, Zhenhu
He, Jianghong
Li, Xiaoli
author_sort Qin, Xuewei
collection PubMed
description Objective: To compare the EEG changes in vegetative state (VS) patients and non-craniotomy, non-vegetative state (NVS) patients during general anesthesia with low-dose propofol and to find whether it affects the arousal rate of VS patients. Methods: Seven vegetative state patients (VS group: five with traumatic brain injury, two with ischemic–hypoxic VS) and five non-craniotomy, non-vegetative state patients (NVS group) treated in the Department of Neurosurgery, Peking University International Hospital from January to May 2022 were selected. All patients were induced with 0.5 mg/kg propofol, and the Bispectral Index (BIS) changes within 5 min after administration were observed. Raw EEG signals and perioperative EEG signals were collected and analyzed using EEGLAB in the MATLAB software environment, time–frequency spectrums were calculated, and EEG changes were analyzed using power spectrums. Results: There was no significant difference in the general data before surgery between the two groups (p > 0.05); the BIS reduction in the VS group was significantly greater than that in the NVS group at 1 min, 2 min, 3 min, 4 min, and 5 min after 0.5 mg/kg propofol induction (p < 0.05). Time–frequency spectrum analysis showed the following: prominent α band energy around 10 Hz and decreased high-frequency energy in the NVS group, decreased high-frequency energy and main energy concentrated below 10 Hz in traumatic brain injury VS patients, higher energy in the 10–20 Hz band in ischemic–hypoxic VS patients. The power spectrum showed that the brain electrical energy of the NVS group was weakened R5 min after anesthesia induction compared with 5 min before induction, mainly concentrated in the small wave peak after 10 Hz, i.e., the α band peak; the energy of traumatic brain injury VS patients was weakened after anesthesia induction, but no α band peak appeared; and in ischemic–hypoxic VS patients, there was no significant change in low-frequency energy after anesthesia induction, high-frequency energy was significantly weakened, and a clear α band peak appeared slightly after 10 Hz. Three months after the operation, follow-up visits were made to the VS group patients who had undergone SCS surgery. One patient with traumatic brain injury VS was diagnosed with MCS-, one patient with ischemic–hypoxic VS had increased their CRS-R score by 1 point, and the remaining five patients had no change in their CRS scores. Conclusions: Low doses of propofol cause great differences in the EEG of different types of VS patients, which may be the unique response of damaged nerve cell residual function to propofol, and these weak responses may also be the basis of brain recovery
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spelling pubmed-106696852023-11-20 EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery Qin, Xuewei Chen, Xuanling Wang, Bo Zhao, Xin Tang, Yi Yao, Lan Liang, Zhenhu He, Jianghong Li, Xiaoli Brain Sci Article Objective: To compare the EEG changes in vegetative state (VS) patients and non-craniotomy, non-vegetative state (NVS) patients during general anesthesia with low-dose propofol and to find whether it affects the arousal rate of VS patients. Methods: Seven vegetative state patients (VS group: five with traumatic brain injury, two with ischemic–hypoxic VS) and five non-craniotomy, non-vegetative state patients (NVS group) treated in the Department of Neurosurgery, Peking University International Hospital from January to May 2022 were selected. All patients were induced with 0.5 mg/kg propofol, and the Bispectral Index (BIS) changes within 5 min after administration were observed. Raw EEG signals and perioperative EEG signals were collected and analyzed using EEGLAB in the MATLAB software environment, time–frequency spectrums were calculated, and EEG changes were analyzed using power spectrums. Results: There was no significant difference in the general data before surgery between the two groups (p > 0.05); the BIS reduction in the VS group was significantly greater than that in the NVS group at 1 min, 2 min, 3 min, 4 min, and 5 min after 0.5 mg/kg propofol induction (p < 0.05). Time–frequency spectrum analysis showed the following: prominent α band energy around 10 Hz and decreased high-frequency energy in the NVS group, decreased high-frequency energy and main energy concentrated below 10 Hz in traumatic brain injury VS patients, higher energy in the 10–20 Hz band in ischemic–hypoxic VS patients. The power spectrum showed that the brain electrical energy of the NVS group was weakened R5 min after anesthesia induction compared with 5 min before induction, mainly concentrated in the small wave peak after 10 Hz, i.e., the α band peak; the energy of traumatic brain injury VS patients was weakened after anesthesia induction, but no α band peak appeared; and in ischemic–hypoxic VS patients, there was no significant change in low-frequency energy after anesthesia induction, high-frequency energy was significantly weakened, and a clear α band peak appeared slightly after 10 Hz. Three months after the operation, follow-up visits were made to the VS group patients who had undergone SCS surgery. One patient with traumatic brain injury VS was diagnosed with MCS-, one patient with ischemic–hypoxic VS had increased their CRS-R score by 1 point, and the remaining five patients had no change in their CRS scores. Conclusions: Low doses of propofol cause great differences in the EEG of different types of VS patients, which may be the unique response of damaged nerve cell residual function to propofol, and these weak responses may also be the basis of brain recovery MDPI 2023-11-20 /pmc/articles/PMC10669685/ /pubmed/38002567 http://dx.doi.org/10.3390/brainsci13111608 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Qin, Xuewei
Chen, Xuanling
Wang, Bo
Zhao, Xin
Tang, Yi
Yao, Lan
Liang, Zhenhu
He, Jianghong
Li, Xiaoli
EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery
title EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery
title_full EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery
title_fullStr EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery
title_full_unstemmed EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery
title_short EEG Changes during Propofol Anesthesia Induction in Vegetative State Patients Undergoing Spinal Cord Stimulation Implantation Surgery
title_sort eeg changes during propofol anesthesia induction in vegetative state patients undergoing spinal cord stimulation implantation surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669685/
https://www.ncbi.nlm.nih.gov/pubmed/38002567
http://dx.doi.org/10.3390/brainsci13111608
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