Open AccessEffect of general anesthesia on neonatal aEEG—A cohort study of patients with non-cardiac congenital anomalies
Author(s) -
Lisanne J. Stolwijk,
Lauren C. Weeke,
Linda S. de Vries,
Maud Y. A. van Herwaarden,
David C. van der Zee,
Desirée B. M. van der Werff,
Ma J. N. L. Benders,
Mona C. Toet,
Petra Lemmers
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0183581
Subject(s) - medicine , anesthesia , gestational age , electroencephalography , burst suppression , sevoflurane , cohort , prospective cohort study , pregnancy , pediatrics , surgery , genetics , psychiatry , biology
The aim of the current study was to determine the effect of general anesthesia on neonatal brain activity using amplitude-integrated EEG (aEEG). Methods A prospective cohort study of neonates (January 2013-December 2015), who underwent major neonatal surgery for non-cardiac congenital anomalies. Anesthesia was administered at the discretion of the anesthetist. aEEG monitoring was started six hours preoperatively until 24 hours after surgery. Analysis of classes of aEEG background patterns, ranging from continuous normal voltage to flat trace in six classes, and quantitative EEG-measures, using spontaneous activity transients (SATs) and interSATintervals (ISI), was performed. Results In total, 111 neonates were included (36 preterm/75 full-term), age at time of surgery was (median (range) 2 (0–32) days. During anesthesia depression of brain activity was seen, with background patterns ranging from flat trace to discontinuous normal voltage. In most patients brain activity was two background pattern classes lower during anesthesia. After cessation of anesthesia, recovery to preoperative brain activity occurred within 24 hours in 86% of the preterm and 96% of the term infants. Gestational age and the dose of sevoflurane were significantly associated with SAT-rate (F(2,68) = 9.288, p < 0.001) and ISI- durations during surgery (F(3,71) = 12.96, p < 0.001). Background pattern and quantitative EEG-values were not associated with brain lesions (χ2(4) = 2.086, ns). Conclusion aEEG shows a variable reduction of brain activity in response to anesthesia in neonates with noncardiac congenital anomalies, with fast recovery after cessation of anesthesia. This reduction is related to gestational age and the dose of sevoflurane. The aEEG offers the opportunity to monitor the depth of anesthesia in the neonate.