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A Retrospective Study of the Patient State Index During General Anesthesia in Infants and Young Children

Zhengzheng Gao1, Jianmin Zhang1, Xuemei Zhang1

  • 1Department of Anaesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Clinical Pediatrics
|April 12, 2023
PubMed

Insights

Patient State Index (PSI) monitoring of anesthesia depth in infants is unreliable. Electroencephalogram (EEG) parameters like spectral edge frequency (SEF) show different associations with PSI in children under and over 1 year old.

Area of Science:

  • Anesthesiology
  • Neuroscience
  • Pediatric Critical Care

Background:

  • Electroencephalogram (EEG) monitoring is crucial for assessing brain function during anesthesia.
  • The Patient State Index (PSI) is an EEG-derived metric intended to quantify anesthetic depth.
  • Limited data exists on PSI accuracy and influencing factors in pediatric populations, especially infants.

Purpose of the Study:

  • To evaluate the Patient State Index (PSI) and its relationship with other electroencephalogram (EEG) parameters in children aged 1 to 36 months undergoing general anesthesia.
  • To identify factors associated with PSI in different pediatric age groups.

Main Methods:

  • Analysis of EEG parameters, including spectral edge frequency (SEF) and burst suppression rate (BSR), in 62 pediatric patients (1-36 months).
  • Patients were stratified into two groups: 1-12 months and 13-36 months.
  • Correlation analysis between PSI, SEF, BSR, blood pressure, heart rate, and age.

Main Results:

  • Younger infants (1-12 months) exhibited lower SEF, PSI, and blood pressure, but higher BSR and heart rate compared to older children (13-36 months).
  • SEF correlated with PSI in both age groups.
  • In children under 1 year, age and blood pressure positively associated with PSI, while BSR negatively associated.
  • Blood pressure did not correlate with PSI in children aged 13-36 months.

Conclusions:

  • The Patient State Index (PSI) may not accurately reflect anesthetic depth in children under 1 year of age.
  • Age and specific EEG parameters like SEF and BSR are important considerations when interpreting PSI in pediatric anesthesia.
  • Further research is needed to validate anesthetic depth monitoring tools in infants.

Keywords:
burst suppressionchildrenelectroencephalogramgeneral anesthesiapatient state indexspectral edge frequency

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