Anesthesia Clinical Trial
Official title:
Comparing EEG Patterns in Different Age Groups During General Anesthesia With Sevoflurane
This study is being conducted to evaluate and assess the electroencephalography wave patterns in different age patients undergoing surgery under general anesthesia. The aim of our study is to compare the raw EEG waves in different age patients and analyze any changes in these patterns among various age groups and which of these groups will have the EEG signal of high-frequency waves or low frequency waves. Previous studies have shown that light sedation is often accompanied by decreasing posterior alpha waves and increasing the intensity of frontal/central beta waves. It is therefore of neuroscientific interest to assess whether the electroencephalographic correlates of sevoflurane-induced unconsciousness have different or similar frequency range among the age groups.
EEG is a powerful tool that refers to the recording of the brain's spontaneous electrical
activity along the scalp and it can be used to measure voltage fluctuations which result from
ionic current flows within neurons found in the brain.The electroencephalogram is
increasingly used to measure anesthetic drug effect on the central nervous system.The use of
electroencephalographic monitors has been proven to decrease drug consumption during
anesthesia and to lead to a faster recovery from anesthesia. Recently, the use of the
Bispectral Index® (BIS®) monitor (Aspect Medical Systems, Newton, MA) has been shown to
decrease the incidence of intraoperative awareness. Depth of anesthesia is frequently
assessed using electroencephalogram processing systems, such as BIS and M-Entropy®
(Datex-Ohmeda, Helsinki, Finland). The use of these monitors has been claimed to allow more
accurate drug administration which has the theoretical benefit of avoiding phases of too
light or too profound anesthesia and the associated risks of hemodynamic instability.
Inadequate general anesthesia caused by under dosage causes intraoperative awareness whereas
prolonged anesthesia increases the risk of postoperative complications because of over
dosage. The most important factor that contributes to the inadequate general anesthesia is
the current limited ability to determine the level of awareness. In this study, the
investigators want to analyze the raw EEG waves under general anesthesia using sevoflurane of
MAC 1.0 for different age groups from 0 to 80 years old. The relation between concentration
of 1.0 MAC sevoflurane and raw EEG states in different age groups is relatively unstudied. In
this prospective randomized study the investigators want to know if there is any correlation
of brain waves under general anesthesia in different age groups. Given that the brain rapidly
develops and undergoes significant changes from childbirth into adulthood, anesthesia induced
EEG oscillations in children might differ from those of adults, and could vary significantly
with age. Characterizing the structure of the EEG in relation to age would help establish the
foundations for age-appropriate monitoring of brain states during general anesthesia and
sedation in children. The investigators aimed to examine the effects of age on the EEG during
general anesthesia, with sevoflurane as the sole hypnotic agent.
After arrival in the operating room, an intravenous line will be inserted into a large
forearm vein, and standard monitors will be applied. Each patient will be continuously
monitored by a 3-lead electrocardiogram, noninvasive arterial pressure, pulse oximetry, and
end-tidal carbon dioxide concentration.
The induction of anesthesia will be the same in all age groups and will consist of sufentanil
0.2-0.3mcg/kg or fentanyl 1-2 mcg/kg before intubation and 0.2 mg/kg cisatracurium to
facilitate intubation. Sevoflurane inhalation will be adjusted in all age groups to maintain
1.0 MAC concentration. After tracheal intubation, patients will be ventilated with a tidal
volume of 6-8 ml/kg and the respiratory rate will be adapted to obtain an end-tidal carbon
dioxide concentration of 30-35 mmHg.
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