Perioperative Medicine  |   August 2017
A Prospective Study of Age-dependent Changes in Propofol-induced Electroencephalogram Oscillations in Children
Author Notes
  • Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts (J.M.L., O.A., K.T., K.J.P., H.D., T.T.H., P.G.F., E.S.S., E.N.B., P.L.P.); Harvard Medical School, Boston, Massachusetts (J.M.L., O.A., P.G.F., E.S.S., E.N.B., P.L.P.); Harvard-Massachusetts Institute of Technology Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts (J.M.L., E.N.B.); Department of Brain and Cognitive Science, Massachusetts Institute of Technology, Cambridge, Massachusetts (E.N.B.); and Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts (E.N.B.).
  • This work has been presented at Massachusetts General Hospital Clinical Research Day on October 9, 2014, at Massachusetts General Hospital, Boston, Massachusetts; the Soma Weiss Student Research Day on January 15, 2015, at the Tosteson Medical Education Center, Harvard Medical School, Boston, Massachusetts; and the International Anesthesia Research Society Annual Meeting on March 23, 2015, in Honolulu, Hawaii.
    This work has been presented at Massachusetts General Hospital Clinical Research Day on October 9, 2014, at Massachusetts General Hospital, Boston, Massachusetts; the Soma Weiss Student Research Day on January 15, 2015, at the Tosteson Medical Education Center, Harvard Medical School, Boston, Massachusetts; and the International Anesthesia Research Society Annual Meeting on March 23, 2015, in Honolulu, Hawaii.×
  • Submitted for publication February 19, 2016. Accepted for publication May 2, 2017.
    Submitted for publication February 19, 2016. Accepted for publication May 2, 2017.×
  • Address correspondence to Dr. Purdon: 149 13th Street, Room 4012, Charlestown, Massachusetts 02129. patrickp@nmr.mgh.harvard.edu. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Clinical Science / Central and Peripheral Nervous Systems / Pediatric Anesthesia / Pharmacology
Perioperative Medicine   |   August 2017
A Prospective Study of Age-dependent Changes in Propofol-induced Electroencephalogram Oscillations in Children
Anesthesiology 8 2017, Vol.127, 293-306. doi:10.1097/ALN.0000000000001717
Anesthesiology 8 2017, Vol.127, 293-306. doi:10.1097/ALN.0000000000001717
Abstract

Background: In adults, frontal electroencephalogram patterns observed during propofol-induced unconsciousness consist of slow oscillations (0.1 to 1 Hz) and coherent alpha oscillations (8 to 13 Hz). Given that the nervous system undergoes significant changes during development, anesthesia-induced electroencephalogram oscillations in children may differ from those observed in adults. Therefore, we investigated age-related changes in frontal electroencephalogram power spectra and coherence during propofol-induced unconsciousness.

Methods: We analyzed electroencephalogram data recorded during propofol-induced unconsciousness in patients between 0 and 21 yr of age (n = 97), using multitaper spectral and coherence methods. We characterized power and coherence as a function of age using multiple linear regression analysis and within four age groups: 4 months to 1 yr old (n = 4), greater than 1 to 7 yr old (n = 16), greater than 7 to 14 yr old (n = 30), and greater than 14 to 21 yr old (n = 47).

Results: Total electroencephalogram power (0.1 to 40 Hz) peaked at approximately 8 yr old and subsequently declined with increasing age. For patients greater than 1 yr old, the propofol-induced electroencephalogram structure was qualitatively similar regardless of age, featuring slow and coherent alpha oscillations. For patients under 1 yr of age, frontal alpha oscillations were not coherent.

Conclusions: Neurodevelopmental processes that occur throughout childhood, including thalamocortical development, may underlie age-dependent changes in electroencephalogram power and coherence during anesthesia. These age-dependent anesthesia-induced electroencephalogram oscillations suggest a more principled approach to monitoring brain states in pediatric patients.