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Published on: January 13, 2018
Effects of dexmedetomidine sedation on the EEG in children
Keira P Mason1, Elizabeth O'Mahony, David Zurakowski
1Departments of Anesthesia, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
Insights
Dexmedetomidine sedation in children produces an electroencephalogram (EEG) similar to natural sleep. This sedation agent does not impede EEG interpretation, making it a valuable tool for pediatric EEG monitoring.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Children with intractable epilepsy require prolonged EEG monitoring during surgical admissions.
- Dexmedetomidine is used for sedation during nuclear medicine imaging in these children.
- Simultaneous EEG monitoring during natural sleep and dexmedetomidine sedation offers a unique comparative analysis.
Purpose of the Study:
- To evaluate the impact of dexmedetomidine sedation on the electroencephalogram (EEG) background and epileptiform activity in children.
- To quantitatively and qualitatively describe dexmedetomidine's effects on pediatric EEG.
- To compare EEG patterns during dexmedetomidine sedation with those during natural sleep.
Main Methods:
- Sixteen children undergoing dexmedetomidine sedation for nuclear medicine studies with concurrent EEG monitoring were studied.
- EEG data during sedation were compared to Stage II natural sleep samples from the same individuals.
- Analysis included visual inspection, power spectrum analysis (delta, theta, alpha, beta, total RMS), and assessment of spike foci and frequency.
Main Results:
- EEG patterns during dexmedetomidine sedation closely resembled Stage II sleep.
- Significant increases in theta (16%), alpha (21%), and beta (40%) power were observed during sedation.
- Spike frequency rose by 47%, but no new epileptiform foci or seizures were detected.
Conclusions:
- Dexmedetomidine sedation induces an EEG pattern comparable to natural Stage II sleep.
- The observed modest increases in theta, alpha, and beta activity do not interfere with EEG interpretation.
- Dexmedetomidine is a potentially useful and effective agent for sedation during pediatric EEG monitoring.
Objectives:
To examine the effects of dexmedetomidine sedation on EEG background and epileptiform activity in children, comparing it to natural sleep.
Aim:
To provide quantitative and qualitative descriptions of the effect of dexmedetomidine sedation on the EEG of children.
Background:
Children with intractable epilepsy admitted for surgery undergo 5 days of continuous EEG monitoring as well as nuclear medicine imaging studies with dexmedetomidine for sedation. Continuous EEG monitoring of each child during both natural sleep and dexmedetomidine-induced sedation provides a unique opportunity to evaluate the effects of dexmedetomidine on the EEG of children.
Materials/Methods:
Sixteen children undergoing dexmedetomidine sedation for nuclear medicine studies and simultaneous continuous EEG monitoring were studied. EEG segments during sedation were compared to samples of naturally occurring stage II sleep from the same child. Standard visual EEG analysis, quantification of delta, theta, alpha, beta, and total RMS power, number and location of spike foci, and frequency of spike activity were compared.
Results:
The EEG during dexmedetomidine sedation resembled stage II sleep. During sedation, statistically significant increases in power of 16% for theta (P = 0.01), 21% for alpha (P = 0.03), and 40% for beta (P < 0.01) were observed, but not for delta (P = 0.63) or total EEG power (P = 0.61). Spike frequency increased by 47% during sedation but no new spike foci or seizures were observed.
Conclusion:
Dexmedetomidine sedation elicited an EEG pattern similar to that of Stage II sleep with modest increases in theta, alpha, and beta activity. Dexmedetomidine does not hinder interpretation of the EEG, suggesting that it may be a uniquely useful agent for EEG sedation in children.
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