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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MDPI AG
2021-12-01
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Online Access: | https://www.mdpi.com/2076-3425/12/1/37 |
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author | Matthias Kreuzer Tobias Kiel Leonie Ernst Marlene Lipp Gerhard Schneider Stefanie Pilge |
author_facet | Matthias Kreuzer Tobias Kiel Leonie Ernst Marlene Lipp Gerhard Schneider Stefanie Pilge |
author_sort | Matthias Kreuzer |
collection | DOAJ |
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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issn | 2076-3425 |
language | English |
last_indexed | 2024-03-10T01:49:19Z |
publishDate | 2021-12-01 |
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spelling | doaj.art-a4f57a043fc94f42a2667637f46181a62023-11-23T13:09:07ZengMDPI AGBrain Sciences2076-34252021-12-011213710.3390/brainsci12010037Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of ResponsivenessMatthias Kreuzer0Tobias Kiel1Leonie Ernst2Marlene Lipp3Gerhard Schneider4Stefanie Pilge5Department of Anesthesiology and Intensive Care, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Anesthesiology and Intensive Care, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Anesthesiology and Intensive Care, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Anesthesiology and Intensive Care, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Anesthesiology and Intensive Care, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyDepartment of Anesthesiology and Intensive Care, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, GermanyPurpose: 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.https://www.mdpi.com/2076-3425/12/1/37anesthesiaanesthesia emergenceelectroencephalogrammonitoring |
spellingShingle | Matthias Kreuzer Tobias Kiel Leonie Ernst Marlene Lipp Gerhard Schneider Stefanie Pilge Evaluation of Anesthetic Specific EEG Dynamics during State Transitions between Loss and Return of Responsiveness Brain Sciences anesthesia anesthesia emergence electroencephalogram monitoring |
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 | anesthesia anesthesia emergence electroencephalogram monitoring |
url | https://www.mdpi.com/2076-3425/12/1/37 |
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