Influence of midazolam premedication on intraoperative EEG signatures in elderly patients
Author(s)Windmann, Victoria; Spies, Claudia; Brown, Emery Neal; Kishnan, Devika; Lichtner, Gregor; Koch, Susanne; ... Show more Show less
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Objective: To investigate the influence of midazolam premedication on the EEG-spectrum before and during general anesthesia in elderly patients. Methods: Patients aged ≥65 years, undergoing elective surgery were included in this prospective observational study. A continuous pre- and intraoperative frontal EEG was recorded in patients who received premedication with midazolam (Mid, n = 15) and patients who did not (noMid, n = 30). Absolute power within the delta (0.5–4 Hz), theta (4–8 Hz), alpha (8–12 Hz), and beta (12–25 Hz) frequency-bands was analyzed in EEG-sections before (pre-induction), and after induction of anesthesia with propofol (post-induction), as well as during general anesthesia with either propofol or volatile-anesthetics (intra-operative). Results: Pre-induction, α-power of Mid patients was lower compared with noMid-patients (α-power: Mid: −10.75 dB vs. noMid: −9.20 dB; p = 0.036). After induction of anesthesia Mid-patients displayed a stronger increase of frontal α-power resulting in higher absolute α-power at post-induction state, (α-power: Mid −3.56 dB vs. noMid: −6.69 dB; p = 0.004), which remained higher intraoperatively (α-power: Mid: −2.12 dB vs. noMid: −6.10 dB; p = 0.024). Conclusion: Midazolam premedication alters the intraoperative EEG-spectrum in elderly patients. Significance: This finding provides further evidence for the role of GABAergic activation in the induction of elevated, frontal α-power during general anesthesia.
DepartmentMassachusetts Institute of Technology. Institute for Medical Engineering and Science; MIT Institute for Data, Systems, and Society; Picower Institute for Learning and Memory; Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences; Harvard University--MIT Division of Health Sciences and Technology
Windmann, Victoria et al. "Influence of midazolam premedication on intraoperative EEG signatures in elderly patients." Clinical Neurophysiology 130, 9 (September 2019): 1673-1681 © 2019 International Federation of Clinical Neurophysiology
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