BJA Advance Access published online on October 26, 2007
British Journal of Anaesthesia, doi:10.1093/bja/aem275
EEG variables as measures of arousal during propofol anaesthesia for general surgery in children: rational selection and age dependence
1 Department of Anaesthesiology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Krankenhausstr. 12, 91054 Erlangen, Germany
2 Department of Anaesthesiology, Centre Hospitalier de Luxembourg, Luxembourg
* Corresponding author. E-mail: christian.jeleazcov{at}kfa.imed.uni-erlangen.de
Background: Clinical benefits of measuring processed EEG during anaesthesia in adults, such as improved recovery and reduced risk of awareness, may also be valid in children. This study evaluated a rational selection of EEG variables as measures of arousal during surgical anaesthesia in children.
Methods: Sixty children undergoing surgical anaesthesia with propofol and remifentanil were enrolled. The performance of 33 single EEG variables and bispectral index (BIS) was assessed by simultaneous analysis of prediction probability (Pk) of Children’s Hospital of Wisconsin Sedation Scores and their signal-to-noise ratio (SNR). Variables performing best in Pk and SNR analysis were selected as potential measures of arousal. Their performance was investigated in five age groups, 0–1, 1–2, 2–5, 5–8, and 8–13 yr.
Results: Single EEG variables such as relative power from frequency bands 13–20 and 20–26 Hz, SEF95, and approximate entropy performed best with Pk>0.59 and SNR>5.50. The Pk and SNR of BIS were 0.71 and 15.76, respectively. Their performance was significantly better in children aged 1–13 yr than in 0–1 yr.
Conclusions: BIS may provide a measure of arousal during propofol anaesthesia in children, but its accuracy is less in infants younger than 12 months. Single EEG variables such as high-frequency components of EEG, SEF95, and approximate entropy may be of limited value to detect arousal in the individual paediatric patient.
Keywords: EEG, anaesthesia, paediatric; monitoring, intraoperative
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