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Using Electroencephalography (EEG) to Guide Propofol and Sevoflurane Dosing in Pediatric Anesthesia
Ian Yuan1, Ting Xu2, Charles Dean Kurth3
1Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Abstract:
Sevoflurane and propofol-based anesthetics are dosed according to vital signs, movement, and expired sevoflurane concentrations, which do not assess the anesthetic state of the brain and, therefore, risk underdose and overdose. Electroencephalography (EEG) measures cortical brain activity and can assess hypnotic depth, a key component of the anesthetic state. Application of sevoflurane and propofol pharmacology along with EEG parameters can more precisely guide dosing to achieve the desired anesthetic state for an individual pediatric patient. This article reviews the principles underlying EEG use for sevoflurane and propofol dosing in pediatric anesthesia and offers case examples to illustrate their use in individual patients.
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