Age-dependent electroencephalogram alterations under remimazolam anesthesia.

Area of Science:

• Anesthesiology
• Neuroscience
• Medical Imaging

Background:

• Remimazolam is a novel benzodiazepine anesthetic for total intravenous anesthesia (TIVA).
• Its electroencephalographic (EEG) signatures, particularly in elderly patients, are not well understood.
• This study investigates age-related EEG changes during remimazolam TIVA.

Purpose of the Study:

• To evaluate the relationship between patient age and intraoperative EEG dynamics.
• To characterize age-specific EEG alterations during remimazolam-based TIVA.
• To assess how age influences EEG components like power, coherence, and spectral parameters.

Main Methods:

• Prospective observational study of 69 adult patients undergoing remimazolam TIVA.
• Analysis of intraoperative electroencephalogram (EEG) recordings.
• Linear regression and Pearson correlation to assess age-related changes in EEG frequency bands, frontal coherence, aperiodic components, burst suppression ratio (BSR), patient state index (PSI), and spectral edge frequency (SEF).

Main Results:

• Older age correlated with decreased absolute alpha, beta, and gamma power.
• Increased relative delta and theta power, and decreased relative alpha and beta power were observed with age.
• Frontal coherence of delta, theta, alpha, and beta oscillations significantly decreased as age increased.

Conclusions:

• Older patients exhibit distinct EEG patterns under remimazolam anesthesia, including reduced alpha/beta power and frontal coherence, and increased delta/theta dominance.
• These age-specific cortical dynamic alterations may influence the interpretation of EEG monitoring during remimazolam anesthesia.
• The findings highlight the importance of considering age when utilizing EEG for anesthesia monitoring with remimazolam.