The effects of morphine and midazolam on EEGs in neonates

We investigated the effect of morphine, midazolam and their active metabolites on background electroencephalogram (EEG) in 6 neonates undergoing extracorporeal membrane oxygenation (ECMO) by conducting simultaneous EEGs and serum drug levels. Despite serum levels that were sufficient to produce adequate sedation, no patients had burst-suppressed or flat EEG backgrounds. We did, however, note that scalp oedema caused by prolonged immobility led to artefactual attenuation of EEG background. We conclude that an EEG prior to sedation will provide important baseline information that allows subsequent comparison and an awareness that scalp oedema after prolonged sedation and immobility will reduce misinterpretation of artefactual EEG attenuation.