Influence of midazolam premedication on intraoperative EEG signatures in elderly patients
Objective: To investigate the influence of midazolam premedication on the EEG-spectrum before and during general anesthesia in elderly patients. Methods: Patients aged ≥65 years, undergoing elective surgery were included in this prospective observational study. A continuous pre- and intraoperative f...
| Main Authors: | , , , , , |
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| Format: | Article |
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Elsevier BV
2020
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| Online Access: | https://hdl.handle.net/1721.1/123878 |
| _version_ | 1826209530812301312 |
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| author | Windmann, Victoria Spies, Claudia Brown, Emery Neal Kishnan, Devika Lichtner, Gregor Koch, Susanne |
| author2 | Picower Institute for Learning and Memory |
| author_facet | Picower Institute for Learning and Memory Windmann, Victoria Spies, Claudia Brown, Emery Neal Kishnan, Devika Lichtner, Gregor Koch, Susanne |
| author_sort | Windmann, Victoria |
| collection | MIT |
| description | Objective: To investigate the influence of midazolam premedication on the EEG-spectrum before and during general anesthesia in elderly patients. Methods: Patients aged ≥65 years, undergoing elective surgery were included in this prospective observational study. A continuous pre- and intraoperative frontal EEG was recorded in patients who received premedication with midazolam (Mid, n = 15) and patients who did not (noMid, n = 30). Absolute power within the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–25 Hz) frequency-bands was analyzed in EEG-sections before (pre-induction), and after induction of anesthesia with propofol (post-induction), as well as during general anesthesia with either propofol or volatile-anesthetics (intra-operative). Results: Pre-induction, α-power of Mid patients was lower compared with noMid-patients (α-power: Mid: −10.75 dB vs. noMid: −9.20 dB; p = 0.036). After induction of anesthesia Mid-patients displayed a stronger increase of frontal α-power resulting in higher absolute α-power at post-induction state, (α-power: Mid −3.56 dB vs. noMid: −6.69 dB; p = 0.004), which remained higher intraoperatively (α-power: Mid: −2.12 dB vs. noMid: −6.10 dB; p = 0.024). Conclusion: Midazolam premedication alters the intraoperative EEG-spectrum in elderly patients. Significance: This finding provides further evidence for the role of GABAergic activation in the induction of elevated, frontal α-power during general anesthesia. Keywords: Physiology (medical); Sensory Systems; Neurology; Clinical Neurology; Premedication; Benzodiazepines – midazolam; EEG; Geriatric anesthesia; Propofol anesthesia |
| first_indexed | 2024-09-23T14:23:56Z |
| format | Article |
| id | mit-1721.1/123878 |
| institution | Massachusetts Institute of Technology |
| last_indexed | 2024-09-23T14:23:56Z |
| publishDate | 2020 |
| publisher | Elsevier BV |
| record_format | dspace |
| spelling | mit-1721.1/1238782022-10-01T21:05:44Z Influence of midazolam premedication on intraoperative EEG signatures in elderly patients Windmann, Victoria Spies, Claudia Brown, Emery Neal Kishnan, Devika Lichtner, Gregor Koch, Susanne Picower Institute for Learning and Memory Harvard University--MIT Division of Health Sciences and Technology Objective: To investigate the influence of midazolam premedication on the EEG-spectrum before and during general anesthesia in elderly patients. Methods: Patients aged ≥65 years, undergoing elective surgery were included in this prospective observational study. A continuous pre- and intraoperative frontal EEG was recorded in patients who received premedication with midazolam (Mid, n = 15) and patients who did not (noMid, n = 30). Absolute power within the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–25 Hz) frequency-bands was analyzed in EEG-sections before (pre-induction), and after induction of anesthesia with propofol (post-induction), as well as during general anesthesia with either propofol or volatile-anesthetics (intra-operative). Results: Pre-induction, α-power of Mid patients was lower compared with noMid-patients (α-power: Mid: −10.75 dB vs. noMid: −9.20 dB; p = 0.036). After induction of anesthesia Mid-patients displayed a stronger increase of frontal α-power resulting in higher absolute α-power at post-induction state, (α-power: Mid −3.56 dB vs. noMid: −6.69 dB; p = 0.004), which remained higher intraoperatively (α-power: Mid: −2.12 dB vs. noMid: −6.10 dB; p = 0.024). Conclusion: Midazolam premedication alters the intraoperative EEG-spectrum in elderly patients. Significance: This finding provides further evidence for the role of GABAergic activation in the induction of elevated, frontal α-power during general anesthesia. Keywords: Physiology (medical); Sensory Systems; Neurology; Clinical Neurology; Premedication; Benzodiazepines – midazolam; EEG; Geriatric anesthesia; Propofol anesthesia Seventh Framework Programme (European Commission) (Grant HEALTH-F2-2014-60246) 2020-02-27T21:19:46Z 2020-02-27T21:19:46Z 2019-07 2019-05 Article http://purl.org/eprint/type/JournalArticle 1388-2457 https://hdl.handle.net/1721.1/123878 Windmann, Victoria et al. "Influence of midazolam premedication on intraoperative EEG signatures in elderly patients." Clinical Neurophysiology, 130, 9 (September 2019): 1673-1681 http://dx.doi.org/10.1016/j.clinph.2019.05.035 Clinical Neurophysiology Creative Commons Attribution-NonCommercial-NoDerivs License http://creativecommons.org/licenses/by-nc-nd/4.0/ application/pdf Elsevier BV Prof. Brown via Courtney Crummett |
| spellingShingle | Windmann, Victoria Spies, Claudia Brown, Emery Neal Kishnan, Devika Lichtner, Gregor Koch, Susanne Influence of midazolam premedication on intraoperative EEG signatures in elderly patients |
| title | Influence of midazolam premedication on intraoperative EEG signatures in elderly patients |
| title_full | Influence of midazolam premedication on intraoperative EEG signatures in elderly patients |
| title_fullStr | Influence of midazolam premedication on intraoperative EEG signatures in elderly patients |
| title_full_unstemmed | Influence of midazolam premedication on intraoperative EEG signatures in elderly patients |
| title_short | Influence of midazolam premedication on intraoperative EEG signatures in elderly patients |
| title_sort | influence of midazolam premedication on intraoperative eeg signatures in elderly patients |
| url | https://hdl.handle.net/1721.1/123878 |
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