A Comparison of Propofol- and Dexmedetomidine-induced Electroencephalogram Dynamics Using Spectral and Coherence Analysis

被引：132

作者：

Akeju, Oluwaseun ^{[1
,4
]}

Pavone, Kara J. ^{[1
]}

Westover, M. Brandon ^{[2
,4
]}

Vazquez, Rafael ^{[1
,4
]}

Prerau, Michael J. ^{[1
,4
]}

Harrell, Priscilla G. ^{[1
,4
]}

Hartnack, Katharine E. ^{[1
]}

Rhee, James ^{[1
,4
]}

Sampson, Aaron L. ^{[1
]}

Habeeb, Kathleen ^{[3
]}

Lei, Gao ^{[1
,4
]}

Pierce, Eric T. ^{[1
,4
]}

Walsh, John L. ^{[1
,4
]}

Brown, Emery N. ^{[1
,4
,5
,6
,7
]}

Purdon, Patrick L. ^{[1
,4
,5
]}

机构：

[1] Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02114 USA

[2] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA

[3] Massachusetts Gen Hosp, Clin Res Ctr, Boston, MA 02114 USA

[4] Harvard Univ, Sch Med, Boston, MA USA

[5] MIT, Dept Brain & Cognit Sci, Cambridge, MA 02139 USA

[6] MIT, Harvard Massachusetts Inst Technol Div Hlth Sci &, Cambridge, MA 02139 USA

[7] MIT, Inst Med Engn & Sci, Cambridge, MA 02139 USA

来源：

ANESTHESIOLOGY | 2014年 / 121卷 / 05期

基金：

美国国家卫生研究院;

关键词：

GENERAL-ANESTHESIA; THALAMOCORTICAL MECHANISMS; INDUCED UNCONSCIOUSNESS; BEHAVIORAL-EXPERIMENTS; BISPECTRAL INDEX; SLEEP; CONSCIOUSNESS; EEG; SEDATION; AROUSAL;

D O I：

10.1097/ALN.0000000000000419

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Background: Electroencephalogram patterns observed during sedation with dexmedetomidine appear similar to those observed during general anesthesia with propofol. This is evident with the occurrence of slow (0.1 to 1 Hz), delta (1 to 4 Hz), propofol-induced alpha (8 to 12 Hz), and dexmedetomidine-induced spindle (12 to 16 Hz) oscillations. However, these drugs have different molecular mechanisms and behavioral properties and are likely accompanied by distinguishing neural circuit dynamics. Methods: The authors measured 64-channel electroencephalogram under dexmedetomidine (n = 9) and propofol (n = 8) in healthy volunteers, 18 to 36 yr of age. The authors administered dexmedetomidine with a 1-mu g/kg loading bolus over 10 min, followed by a 0.7 mu g kg(-1) h(-1) infusion. For propofol, the authors used a computer-controlled infusion to target the effect-site concentration gradually from 0 to 5 g/ml. Volunteers listened to auditory stimuli and responded by button press to determine unconsciousness. The authors analyzed the electroencephalogram using multitaper spectral and coherence analysis. Results: Dexmedetomidine was characterized by spindles with maximum power and coherence at approximately 13 Hz (mean SD; power, -10.8 +/- 3.6 dB; coherence, 0.8 +/- 0.08), whereas propofol was characterized with frontal alpha oscillations with peak frequency at approximately 11 Hz (power, 1.1 +/- 4.5 dB; coherence, 0.9 +/- 0.05). Notably, slow oscillation power during a general anesthetic state under propofol (power, 13.2 +/- 2.4 dB) was much larger than during sedative states under both propofol (power, -2.5 +/- 3.5 dB) and dexmedetomidine (power, -0.4 +/- 3.1 dB). Conclusion: The results indicate that dexmedetomidine and propofol place patients into different brain states and suggest that propofol enables a deeper state of unconsciousness by inducing large-amplitude slow oscillations that produce prolonged states of neuronal silence.

引用

页码：978 / 989

页数：12

共 37 条

[1] The comparison of the effects of dexmedetomidine and midazolam sedation on electroencephalography in pediatric patients with febrile convulsion [J].