Frequency Analysis of Raw EEG During Sevoflurane Anesthesia in Children Younger Than 2 Years Old

Sang-Hwan Ji50 enrolled

Overview

The purpose of this study is to analyze raw electroencephalogram in infants younger than 2 years old undergoing general anesthesia using sevoflurane.

After obtaining an informed consent from one of the parents, patients undergo routine anesthetic induction using sodium thiopental. Bispectral index and patient state index are both monitored simultaneously. Raw electroencephalogram data are transmitted and recorded via a dedicated equipment. Anesthesia is maintained using sevoflurane with end-tidal level of less than 2 minimum alveolar concentration (MAC) adjusted to age. Fentanyl of up to 1 mcg/kg can be administered in case of increased heart rate and mean blood pressure with a degree of 30% of baseline. During anesthesia, patients' status of sedation is defined as 'maintenance of surgical state of anesthesia (MOSSA)' when the end-tidal concentration of sevoflurane is maintained between 0.7 and 1.3 MAC and mean blood pressure and heart rate is between 80-120% of baseline. 'Emergence' is defined as a 3-minute period in the middle of continuous decrease in end-tidal concentration of sevoflurane in the range of less than 0.7 MAC and finally reaching 0.2 MAC. Raw electroencephalogram waves are analyzed by distribution of power along frequency bands and compared according to the state of anesthesia or bispectral index / patient state index value.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Anesthesia, General Sevoflurane Infant

Interventions

BISDEVICE

Bispectral index monitoring

PSiDEVICE

Patient state index monitoring

Eligibility

Sex: ALLMin age: 4 MonthsMax age: 23 Months

Medical Language ↔ Plain English

Inclusion Criteria: * Pediatric patients aged between 4 months and 2 years planned to undergo surgery under general anesthesia * American Society of Anesthesiologists physical status 1 or 2 Exclusion Criteria: * History of preterm birth (postconceptual age \< 32 wks) or history of mechanical ventilation immediately after birth * Presence of genetic disease or chromosomal abnormality that can affect brain development * Presence of disease in central nervous system * History of head trauma or surgery involving head * History of hypersensitivity to anesthetic drugs * Intubated or sedated state before induction of anesthesia * Difficulty in attaching both the bispectral index and patient state index probes to patient's forehead * Expected operation time of less than 5 minutes

Locations (1)

Seoul National University Hospital

Seoul, South Korea

Outcomes

Primary Outcomes

Frequency analysis

Distribution of raw electroencephalogram waves along frequency bands according to state of anesthesia

Time frame: From start of anesthesia to end of anesthesia, less than 24 hours

Secondary Outcomes

Prediction probability

Prediction probability of bispectral index and patient state index for maintenance of surgical state of anesthesia

Time frame: From start of anesthesia to end of anesthesia, less than 24 hours

Coherence of BIS and PSi

Coherence of BIS and PSi for prediction of state of anesthesia

Time frame: From start of anesthesia to end of anesthesia, less than 24 hours

Emergence delirium and frequency analysis

Relationship of distribution of electroencephalogram along frequency band at the 'emergence' state and appearance of emergence delirium at the postanesthesia care unit

Time frame: From start of anesthesia to end of anesthesia, less than 24 hours

Data from ClinicalTrials.gov

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