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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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Creative Commons Attribution-NonCommercial-NoDerivs License http://creativecommons.org/licenses/by-nc-nd/4.0/
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Abstract
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.
Date issued
2019-09
URI
https://hdl.handle.net/1721.1/125942
Department
Massachusetts Institute of Technology. Institute for Medical Engineering & Science; Massachusetts Institute of Technology. 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
Journal
Clinical Neurophysiology
Publisher
Elsevier BV
Citation
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
Version: Author's final manuscript
ISSN
1388-2457

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