Processed EEG Monitoring During Pediatric Procedural Sedation: Correlation Between the Narcotrend Index and the...

Area of Science:

• Pediatric Anesthesiology
• Neurophysiology
• Clinical Monitoring

Background:

• Objective assessment of pediatric sedation depth is challenging.
• Processed electroencephalogram (pEEG) systems like the Narcotrend monitor offer continuous sedation depth information.
• Maintaining spontaneous breathing and protective reflexes during sedation is crucial in children.

Purpose of the Study:

• To investigate the correlation between the Narcotrend Index (NI) and the Pediatric Sedation State Scale (PSSS).
• To evaluate the utility of pEEG monitoring for procedural sedation in children.
• To assess sedation depth during propofol and fentanyl administration.

Main Methods:

• Included children and adolescents (6 months to 17 years) undergoing procedural sedation.
• Assessed sedation depth using the Narcotrend monitor and PSSS.
• Calculated Spearman's rank correlation coefficient to analyze the NI and PSSS relationship.

Main Results:

• Analyzed 311 paired measurements from 29 patients.
• Found a moderate to good correlation between NI and PSSS (r=0.61).
• Median NI for deep sedation (PSSS 2) was 39 (IQR 30-50).

Conclusions:

• The Narcotrend Index (NI) correlates acceptably with the Pediatric Sedation State Scale (PSSS).
• pEEG monitoring with NI can be a valuable adjunct for optimizing pediatric procedural sedation.
• This monitoring may help prevent both over-sedation and inadequate sedation in pediatric patients.