Duration of EEG suppression does not predict recovery time or degree of cognitive impairment after general anaesthesia in human volunteers.

Autor:	Shortal BP; Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA, USA., Hickman LB; Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA., Mak-McCully RA; Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Wang W; Department of Mathematics, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA., Brennan C; Neuroscience Graduate Group, University of Pennsylvania, Philadelphia, PA, USA., Ung H; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA., Litt B; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA., Tarnal V; Center for Consciousness Science, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA., Janke E; Center for Consciousness Science, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA., Picton P; Center for Consciousness Science, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA., Blain-Moraes S; School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada., Maybrier HR; Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA., Muench MR; Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA., Lin N; Department of Mathematics, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO, USA., Avidan MS; Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA., Mashour GA; Center for Consciousness Science, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA., McKinstry-Wu AR; Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Kelz MB; Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., Palanca BJ; Department of Anesthesiology, Washington University in St. Louis, St. Louis, MO, USA., Proekt A; School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada; Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: proekta@uphs.upenn.edu.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2019 Aug; Vol. 123 (2), pp. 206-218. Date of Electronic Publication: 2019 Jun 13.
DOI:	10.1016/j.bja.2019.03.046
Abstrakt:	Background: Burst suppression occurs in the EEG during coma and under general anaesthesia. It has been assumed that burst suppression represents a deeper state of anaesthesia from which it is more difficult to recover. This has not been directly demonstrated, however. Here, we test this hypothesis directly by assessing relationships between EEG suppression in human volunteers and recovery of consciousness. Methods: We recorded the EEG of 27 healthy humans (nine women/18 men) anaesthetised with isoflurane 1.3 minimum alveolar concentration (MAC) for 3 h. Periods of EEG suppression and non-suppression were separated using principal component analysis of the spectrogram. After emergence, participants completed the digit symbol substitution test and the psychomotor vigilance test. Results: Volunteers demonstrated marked variability in multiple features of the suppressed EEG. In order to test the hypothesis that, for an individual subject, inclusion of features of suppression would improve accuracy of a model built to predict time of emergence, two types of models were constructed: one with a suppression-related feature included and one without. Contrary to our hypothesis, Akaike information criterion demonstrated that the addition of a suppression-related feature did not improve the ability of the model to predict time to emergence. Furthermore, the amounts of EEG suppression and decrements in cognitive task performance relative to pre-anaesthesia baseline were not significantly correlated. Conclusions: These findings suggest that, in contrast to current assumptions, EEG suppression in and of itself is not an important determinant of recovery time or the degree of cognitive impairment upon emergence from anaesthesia in healthy adults. (Published by Elsevier Ltd.)
Databáze:	MEDLINE
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