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Published on: January 29, 2014
The auditory evoked potential and paediatric anaesthesia
S W O'Kelly1, D C Smith, S N Pilkington
1Shackleton Department of Anaesthesia, Southampton General Hospital.
Insights
Auditory evoked responses (AER) in children under two years old are often unreliable due to irregular patterns and superimposed ECG artifact. Modifications to current methods may be needed for pediatric anesthesia practice.
Area of Science:
- Neuroscience
- Anesthesiology
- Pediatrics
Background:
- Auditory evoked responses (AER) are used to assess auditory pathway function.
- Reliable AER measurement is crucial in pediatric anesthesia for monitoring neurological status.
Purpose of the Study:
- To evaluate the reliability of AER in children undergoing general anesthesia.
- To identify age-related differences in AER patterns and potential confounding factors.
Main Methods:
- Examined raw electroencephalogram (EEG) and AER in 35 children (3 days to 13 years) under general anesthesia.
- Presented binaural stimuli at 6.12 Hz, recording EEG with specialized software.
- Averaged 512 sweeps (125 ms duration) to generate AER.
Main Results:
- AER patterns were irregular in children under 2 years old.
- Children older than 2 years exhibited AER patterns similar to adults.
- ECG artifact, synchronized with heart rate, often superimposed EEG in younger children.
Conclusions:
- AER may be unreliable in children under 2 years old.
- Current AER methodology may require modification for pediatric anesthetic applications.
- Further research is needed to optimize AER techniques for infants and young children.
Abstract:
We have examined the raw EEG activity and auditory evoked responses (AER) in 35 children, aged 3 days to 13 yr (median 1.5 yr), undergoing general anaesthesia for routine surgery. Binaural stimuli were presented at a frequency of 6.12 Hz and the EEG was recorded and stored using the Northwick Park auditory evoked response software. AER were generated by averaging 512 sweeps each of 125-ms duration. In children less than 2 yr of age, the AER was often irregular, whereas children older than 2 yr had AER patterns similar to those in adults. In children less than 2 yr, regular artefact activity was superimposed on the background EEG which was at the same frequency as the instantaneous heart rate and which was often identifiable as the ECG. We conclude that the AER may be unreliable in children less than 2 yr of age, and modification of current methodology may be required if this technique is to become useful in paediatric anaesthetic practice.
