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Updated: Jul 9, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
The electroencephalograph during anesthesia and emergence in infants and children
Andrew J Davidson1, Steven M Sale, Connie Wong
1Department of Anaesthesia & Pain Management, Royal Children's Hospital, Melbourne, Australia. andrew.davidson@rch.org.au
Insights
The electroencephalogram (EEG) in infants during anesthesia differs significantly from older children, showing a discontinuous pattern. This highlights the need for infant-specific algorithms in EEG-based anesthesia depth monitoring.
Area of Science:
- Pediatric Anesthesiology
- Neurophysiology
- Medical Devices
Background:
- Electroencephalogram (EEG) characteristics during pediatric anesthesia are not well-defined.
- Understanding EEG patterns can improve the performance of anesthesia depth monitors in children.
- This study investigates age-related EEG changes in infants and children under anesthesia.
Purpose of the Study:
- To describe the association between age and basic EEG characteristics in children and infants.
- To provide data for developing and validating EEG-derived anesthesia depth monitoring tools for pediatric populations.
Main Methods:
- Observational study of 64 children (9 days to 12 years) undergoing anesthesia.
- EEG recorded using a BRM2 brain monitor; 90% spectral edge frequency (SEF-90) and power analyzed.
- Children categorized into three age groups: 0-6 months, 6-24 months, and 2-12 years.
Main Results:
- EEG power significantly decreased from anesthesia equilibrium to emergence in children aged 6-24 months and 2-12 years, but not in infants (0-6 months).
- Mean forehead SEF-90 increased in 2-12 year olds but showed no significant change in younger age groups.
- Infants exhibited a discontinuous EEG pattern with bursts and low amplitude during emergence.
Conclusions:
- Infant EEG during anesthesia is markedly different from that of older children.
- Development of specialized, infant-derived algorithms is crucial for accurate EEG-based anesthesia depth monitoring in neonates and infants.
Background:
The characteristics of the electroencephalogram (EEG) during anesthesia in children are poorly described. An understanding of the EEG during anesthesia may help explain and predict the performance of EEG-derived depth of anesthesia monitors in children. This study aims to describe the association between age and some basic characteristics of the EEG during nonstandardized anesthesia in children and infants.
Methods:
Sixty-four children aged 9 days to 12 years were enrolled in this observational physiological study. Anesthesia was given at the discretion of the anesthetist. EEG was recorded from after induction to emergence using a BRM2 brain monitor ''BrainZ Instruments, Auckland, New Zealand'' in parietal and frontal montages. For comparison, 90% spectral edge frequency (SEF-90) and power were determined at three points (equilibrium during anesthesia, when the volatile agent was discontinued and at emergence), and children were divided into three age groups (0-6 months, 6-24 months and 2-12 years).
Results:
Fifty-seven children had artifact-free EEG data. From equilibrium to emergence the mean forehead power decreased substantially in children aged 2-12 years (3171-153 microV(2), P < 0.001) and 6-24 months (756-140 microV(2), P < 0.001) but no difference was found in infants aged 0-6 months (93-63 microV(2), P = 0.4). From equilibrium to emergence mean forehead spectral edge frequency increased in children aged 2-12 years (10.8-13.7 Hz, P = 0.01) but no change was found in children aged 6-24 months (12.7-12.7 Hz, P = 0.9) or 0-6 months (9.45-7.26 Hz, P = 0.08). Throughout emergence, infants demonstrated a discontinuous EEG pattern with intermittent bursts separated with low amplitude.
Conclusions:
During anesthesia, the EEG in infants is fundamentally different from the EEG in older children. This study supports the need for specific infant-derived algorithms if EEG-derived anesthesia depth monitors are to be used in infants.
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