Journal article
Comorbidity-dependent changes in alpha and broadband electroencephalogram power during general anaesthesia for cardiac surgery.
- Kaiser HA Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland. Electronic address: heiko.kaiser@insel.ch.
- Hirschi T Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
- Sleigh C Department of Mathematics, University of Auckland, Auckland, New Zealand.
- Reineke D Department of Cardiovascular Surgery, University Hospital Bern, Inselspital, Bern, Switzerland.
- Hartwich V Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
- Stucki M Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
- Rummel C University of Bern, Support Center for Advanced Neuroimaging, University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern, Switzerland.
- Sleigh J Department of Anaesthesia, Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
- Hight D Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
- 2020-08-05
Published in:
- British journal of anaesthesia. - 2020
age
alpha power
comorbidity
depth of anaesthesia
electroencephalogram
general anaesthesia
intraoperative EEG
monitoring
Adult
Age Factors
Aged
Anesthesia, General
Cardiac Surgical Procedures
Comorbidity
Electroencephalography
Female
Humans
Male
Middle Aged
Prospective Studies
English
BACKGROUND
Age and comorbidities are reported to induce neurobiological transformations in the brain. Whilst the influence of ageing on anaesthesia-induced electroencephalogram (EEG) changes has been investigated, the effect of comorbidities has not yet been explored. We hypothesised that certain diseases significantly affect frontal EEG alpha and broadband power in cardiac surgical patients.
METHODS
We analysed the frontal EEGs of 589 patients undergoing isoflurane general anaesthesia from a prospective observational study. We used multi- and uni-variable regression to analyse the relationships between comorbidities and age as independent with peak and oscillatory alpha, and broadband power as dependent variables. A score of comorbidities and minimum alveolar concentration (MAC) was built to interrogate the combined effect of age and score on alpha and broadband power.
RESULTS
At the univariable level, many comorbidities were associated with lower EEG alpha or broadband power. Multivariable regression indicated the independent association of numerous comorbidities and MAC with peak alpha (R2=0.19) and broadband power (R2=0.31). The association with peak alpha power is markedly reduced when the underlying broadband effect is subtracted (R2=0.09). Broadband measures themselves are more strongly correlated with comorbidities and MAC (R2=0.31) than age (R2=0.15).
CONCLUSIONS
Comorbidities and age are independently associated with decreasing frontal EEG alpha and broadband power during general anaesthesia. For alpha power, the association is highly dependent on the underlying broadband effect. These findings might have significant clinical consequences for automated computation for depth of anaesthesia in comorbid patients, because misclassification might pose the risk of under- or over-dosing of anaesthetics.
CLINICAL TRIAL REGISTRATION
NCT02976584.
Age and comorbidities are reported to induce neurobiological transformations in the brain. Whilst the influence of ageing on anaesthesia-induced electroencephalogram (EEG) changes has been investigated, the effect of comorbidities has not yet been explored. We hypothesised that certain diseases significantly affect frontal EEG alpha and broadband power in cardiac surgical patients.
METHODS
We analysed the frontal EEGs of 589 patients undergoing isoflurane general anaesthesia from a prospective observational study. We used multi- and uni-variable regression to analyse the relationships between comorbidities and age as independent with peak and oscillatory alpha, and broadband power as dependent variables. A score of comorbidities and minimum alveolar concentration (MAC) was built to interrogate the combined effect of age and score on alpha and broadband power.
RESULTS
At the univariable level, many comorbidities were associated with lower EEG alpha or broadband power. Multivariable regression indicated the independent association of numerous comorbidities and MAC with peak alpha (R2=0.19) and broadband power (R2=0.31). The association with peak alpha power is markedly reduced when the underlying broadband effect is subtracted (R2=0.09). Broadband measures themselves are more strongly correlated with comorbidities and MAC (R2=0.31) than age (R2=0.15).
CONCLUSIONS
Comorbidities and age are independently associated with decreasing frontal EEG alpha and broadband power during general anaesthesia. For alpha power, the association is highly dependent on the underlying broadband effect. These findings might have significant clinical consequences for automated computation for depth of anaesthesia in comorbid patients, because misclassification might pose the risk of under- or over-dosing of anaesthetics.
CLINICAL TRIAL REGISTRATION
NCT02976584.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.bja.2020.06.054
- PMID 32747077
- Persistent URL
- https://sonar.ch/global/documents/132245
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