Anesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case report
Abstract Background Low frontal alpha power is an electroencephalogram phenotype suggesting vulnerability to anesthetics. This phenotype for a “vulnerable brain” carries risks for burst suppression at lower-than-expected anesthetic concentrations and therefore for postoperative delirium. Case presen...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-05-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-023-00616-w |
| _version_ | 1797822947357884416 |
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| author | Ryo Wakabayashi |
| author_facet | Ryo Wakabayashi |
| author_sort | Ryo Wakabayashi |
| collection | DOAJ |
| description | Abstract Background Low frontal alpha power is an electroencephalogram phenotype suggesting vulnerability to anesthetics. This phenotype for a “vulnerable brain” carries risks for burst suppression at lower-than-expected anesthetic concentrations and therefore for postoperative delirium. Case presentation A 73-year-old man underwent a laparoscopic Miles’ operation. He was monitored with a bispectral index monitor. Before the skin incision, the fraction of age-adjusted minimum alveolar concentration of desflurane was 0.48, and a spectrogram showed slow-delta oscillation despite a bispectral index value of 38–48. Although the fraction of age-adjusted minimum alveolar concentration of desflurane decreased to 0.33, the EEG signature remained unchanged, along with a similar bispectral index value. No burst suppression patterns were observed throughout the whole procedure, and he did not experience postoperative delirium. Conclusions This case suggests that monitoring of electroencephalogram signatures is helpful for detecting patients with a “vulnerable brain” and for providing optimal anesthetic depth in such patients. |
| first_indexed | 2024-03-13T10:16:46Z |
| format | Article |
| id | doaj.art-70068f32ee964bac987c248941453e68 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-03-13T10:16:46Z |
| publishDate | 2023-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-70068f32ee964bac987c248941453e682023-05-21T11:10:42ZengSpringerOpenJA Clinical Reports2363-90242023-05-01911510.1186/s40981-023-00616-wAnesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case reportRyo Wakabayashi0Department of Anesthesia, Nagano Red Cross HospitalAbstract Background Low frontal alpha power is an electroencephalogram phenotype suggesting vulnerability to anesthetics. This phenotype for a “vulnerable brain” carries risks for burst suppression at lower-than-expected anesthetic concentrations and therefore for postoperative delirium. Case presentation A 73-year-old man underwent a laparoscopic Miles’ operation. He was monitored with a bispectral index monitor. Before the skin incision, the fraction of age-adjusted minimum alveolar concentration of desflurane was 0.48, and a spectrogram showed slow-delta oscillation despite a bispectral index value of 38–48. Although the fraction of age-adjusted minimum alveolar concentration of desflurane decreased to 0.33, the EEG signature remained unchanged, along with a similar bispectral index value. No burst suppression patterns were observed throughout the whole procedure, and he did not experience postoperative delirium. Conclusions This case suggests that monitoring of electroencephalogram signatures is helpful for detecting patients with a “vulnerable brain” and for providing optimal anesthetic depth in such patients.https://doi.org/10.1186/s40981-023-00616-wElectroencephalogramMinimum alveolar concentrationPostoperative deliriumVulnerable brain |
| spellingShingle | Ryo Wakabayashi Anesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case report JA Clinical Reports Electroencephalogram Minimum alveolar concentration Postoperative delirium Vulnerable brain |
| title | Anesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case report |
| title_full | Anesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case report |
| title_fullStr | Anesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case report |
| title_full_unstemmed | Anesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case report |
| title_short | Anesthetic management of a patient with an electroencephalogram phenotype for a “vulnerable brain”: a case report |
| title_sort | anesthetic management of a patient with an electroencephalogram phenotype for a vulnerable brain a case report |
| topic | Electroencephalogram Minimum alveolar concentration Postoperative delirium Vulnerable brain |
| url | https://doi.org/10.1186/s40981-023-00616-w |
| work_keys_str_mv | AT ryowakabayashi anestheticmanagementofapatientwithanelectroencephalogramphenotypeforavulnerablebrainacasereport |