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Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness

Purpose: electroencephalographic (EEG) information is used to monitor the level of cortical depression of a patient undergoing surgical intervention under general anesthesia. The dynamic state transitions into and out of anesthetic-induced loss and return of responsiveness (LOR, ROR) present a possi...

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Autores principales: Kreuzer, Matthias, Kiel, Tobias, Ernst, Leonie, Lipp, Marlene, Schneider, Gerhard, Pilge, Stefanie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773581/
https://www.ncbi.nlm.nih.gov/pubmed/35053781
http://dx.doi.org/10.3390/brainsci12010037
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author Kreuzer, Matthias
Kiel, Tobias
Ernst, Leonie
Lipp, Marlene
Schneider, Gerhard
Pilge, Stefanie
author_facet Kreuzer, Matthias
Kiel, Tobias
Ernst, Leonie
Lipp, Marlene
Schneider, Gerhard
Pilge, Stefanie
author_sort Kreuzer, Matthias
collection PubMed
description Purpose: electroencephalographic (EEG) information is used to monitor the level of cortical depression of a patient undergoing surgical intervention under general anesthesia. The dynamic state transitions into and out of anesthetic-induced loss and return of responsiveness (LOR, ROR) present a possibility to evaluate the dynamics of the EEG induced by different substances. We evaluated changes in the EEG power spectrum during anesthesia emergence for three different anesthetic regimens. We also assessed the possible impact of these changes on processed EEG parameters such as the permutation entropy (PeEn) and the cerebral state index (CSI). Methods: we analyzed the EEG from 45 patients, equally assigned to three groups. All patients were induced with propofol and the groups differed by the maintenance anesthetic regimen, i.e., sevoflurane, isoflurane, or propofol. We evaluated the EEG and parameter dynamics during LOR and ROR. For the emergence period, we focused on possible differences in the EEG dynamics in the different groups. Results: depending on the substance, the EEG emergence patterns showed significant differences that led to a substance-specific early activation of higher frequencies as indicated by the “wake” CSI values that occurred minutes before ROR in the inhalational anesthetic groups. Conclusion: our results highlight substance-specific differences in the emergence from anesthesia that can influence the EEG-based monitoring that probably have to be considered in order to improve neuromonitoring during general anesthesia.
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spelling pubmed-87735812022-01-21 Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness Kreuzer, Matthias Kiel, Tobias Ernst, Leonie Lipp, Marlene Schneider, Gerhard Pilge, Stefanie Brain Sci Article Purpose: electroencephalographic (EEG) information is used to monitor the level of cortical depression of a patient undergoing surgical intervention under general anesthesia. The dynamic state transitions into and out of anesthetic-induced loss and return of responsiveness (LOR, ROR) present a possibility to evaluate the dynamics of the EEG induced by different substances. We evaluated changes in the EEG power spectrum during anesthesia emergence for three different anesthetic regimens. We also assessed the possible impact of these changes on processed EEG parameters such as the permutation entropy (PeEn) and the cerebral state index (CSI). Methods: we analyzed the EEG from 45 patients, equally assigned to three groups. All patients were induced with propofol and the groups differed by the maintenance anesthetic regimen, i.e., sevoflurane, isoflurane, or propofol. We evaluated the EEG and parameter dynamics during LOR and ROR. For the emergence period, we focused on possible differences in the EEG dynamics in the different groups. Results: depending on the substance, the EEG emergence patterns showed significant differences that led to a substance-specific early activation of higher frequencies as indicated by the “wake” CSI values that occurred minutes before ROR in the inhalational anesthetic groups. Conclusion: our results highlight substance-specific differences in the emergence from anesthesia that can influence the EEG-based monitoring that probably have to be considered in order to improve neuromonitoring during general anesthesia. MDPI 2021-12-28 /pmc/articles/PMC8773581/ /pubmed/35053781 http://dx.doi.org/10.3390/brainsci12010037 Text en © 2021 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
Kreuzer, Matthias
Kiel, Tobias
Ernst, Leonie
Lipp, Marlene
Schneider, Gerhard
Pilge, Stefanie
Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness
title Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness
title_full Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness
title_fullStr Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness
title_full_unstemmed Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness
title_short Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness
title_sort evaluation of anesthetic specific eeg dynamics during state transitions between loss and return of responsiveness
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773581/
https://www.ncbi.nlm.nih.gov/pubmed/35053781
http://dx.doi.org/10.3390/brainsci12010037
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