Effects of Sevoflurane and Propofol on Frontal Electroencephalogram Power and Coherence

被引:252
作者
Akeju, Oluwaseun [1 ,3 ]
Westover, M. Brandon [2 ,4 ]
Pavone, Kara J. [1 ]
Sampson, Aaron L. [1 ]
Hartnack, Katharine E. [1 ]
Brown, Emery N. [1 ,3 ,4 ,5 ,6 ]
Purdon, Patrick L. [1 ,3 ,4 ]
机构
[1] Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02114 USA
[2] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA
[3] Harvard Univ, Sch Med, Boston, MA USA
[4] MIT, Dept Brain & Cognit Sci, Cambridge, MA 02139 USA
[5] MIT, Harvard Massachusetts Inst Technol Div Hlth Sci &, Cambridge, MA 02139 USA
[6] MIT, Inst Med Engn & Sci, Cambridge, MA 02139 USA
基金
美国国家卫生研究院;
关键词
INDUCED ALPHA-RHYTHM; GENERAL-ANESTHESIA; INDUCED UNCONSCIOUSNESS; INHALED ANESTHETICS; CALCIUM CURRENTS; CONSCIOUSNESS; MECHANISMS; ISOFLURANE; NEURONS; SLEEP;
D O I
10.1097/ALN.0000000000000436
中图分类号
R614 [麻醉学];
学科分类号
100217 [麻醉学];
摘要
Background: The neural mechanisms of anesthetic vapors have not been studied in depth. However, modeling and experimental studies on the intravenous anesthetic propofol indicate that potentiation of -aminobutyric acid receptors leads to a state of thalamocortical synchrony, observed as coherent frontal alpha oscillations, associated with unconsciousness. Sevoflurane, an ether derivative, also potentiates -aminobutyric acid receptors. However, in humans, sevoflurane-induced coherent frontal alpha oscillations have not been well detailed. Methods: To study the electroencephalogram dynamics induced by sevoflurane, the authors identified age- and sex-matched patients in which sevoflurane (n = 30) or propofol (n = 30) was used as the sole agent for maintenance of general anesthesia during routine surgery. The authors compared the electroencephalogram signatures of sevoflurane with that of propofol using time-varying spectral and coherence methods. Results: Sevoflurane general anesthesia is characterized by alpha oscillations with maximum power and coherence at approximately 10 Hz, (mean SD; peak power, 4.3 +/- 3.5 dB; peak coherence, 0.73 +/- 0.1). These alpha oscillations are similar to those observed during propofol general anesthesia, which also has maximum power and coherence at approximately 10 Hz (peak power, 2.1 +/- 4.3 dB; peak coherence, 0.71 +/- 0.1). However, sevoflurane also exhibited a distinct theta coherence signature (peak frequency, 4.9 +/- 0.6 Hz; peak coherence, 0.58 +/- 0.1). Slow oscillations were observed in both cases, with no significant difference in power or coherence. Conclusions: The study results indicate that sevoflurane, like propofol, induces coherent frontal alpha oscillations and slow oscillations in humans to sustain the anesthesia-induced unconscious state. These results suggest a shared molecular and systems-level mechanism for the unconscious state induced by these drugs.
引用
收藏
页码:990 / 998
页数:9
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