Frequency Analysis of Raw EEG During Sevoflurane Anesthesia in Children Younger Than 2 Years Old

NCT ID: NCT05148065

Last Updated: 2023-06-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-12-15

Study Completion Date

2023-05-15

Brief Summary

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The purpose of this study is to analyze raw electroencephalogram in infants younger than 2 years old undergoing general anesthesia using sevoflurane.

Detailed Description

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After obtaining an informed consent from one of the parents, patients undergo routine anesthetic induction using sodium thiopental. Bispectral index and patient state index are both monitored simultaneously. Raw electroencephalogram data are transmitted and recorded via a dedicated equipment. Anesthesia is maintained using sevoflurane with end-tidal level of less than 2 minimum alveolar concentration (MAC) adjusted to age. Fentanyl of up to 1 mcg/kg can be administered in case of increased heart rate and mean blood pressure with a degree of 30% of baseline.

During anesthesia, patients' status of sedation is defined as 'maintenance of surgical state of anesthesia (MOSSA)' when the end-tidal concentration of sevoflurane is maintained between 0.7 and 1.3 MAC and mean blood pressure and heart rate is between 80-120% of baseline.

'Emergence' is defined as a 3-minute period in the middle of continuous decrease in end-tidal concentration of sevoflurane in the range of less than 0.7 MAC and finally reaching 0.2 MAC.

Raw electroencephalogram waves are analyzed by distribution of power along frequency bands and compared according to the state of anesthesia or bispectral index / patient state index value.

Conditions

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Anesthesia, General Sevoflurane Infant

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

PROSPECTIVE

Interventions

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BIS

Bispectral index monitoring

Intervention Type DEVICE

PSi

Patient state index monitoring

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Pediatric patients aged between 4 months and 2 years planned to undergo surgery under general anesthesia
* American Society of Anesthesiologists physical status 1 or 2

Exclusion Criteria

* History of preterm birth (postconceptual age \< 32 wks) or history of mechanical ventilation immediately after birth
* Presence of genetic disease or chromosomal abnormality that can affect brain development
* Presence of disease in central nervous system
* History of head trauma or surgery involving head
* History of hypersensitivity to anesthetic drugs
* Intubated or sedated state before induction of anesthesia
* Difficulty in attaching both the bispectral index and patient state index probes to patient's forehead
* Expected operation time of less than 5 minutes
Minimum Eligible Age

4 Months

Maximum Eligible Age

23 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sang-Hwan Ji

OTHER

Sponsor Role lead

Responsible Party

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Sang-Hwan Ji

Clinical assistant professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Sang-Hwan Ji, M.D., Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Seoul National University Hospital

Locations

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Seoul National University Hospital

Seoul, , South Korea

Site Status

Countries

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South Korea

References

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Brown EN, Lydic R, Schiff ND. General anesthesia, sleep, and coma. N Engl J Med. 2010 Dec 30;363(27):2638-50. doi: 10.1056/NEJMra0808281. No abstract available.

Reference Type BACKGROUND
PMID: 21190458 (View on PubMed)

Myles PS, Leslie K, McNeil J, Forbes A, Chan MT. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. Lancet. 2004 May 29;363(9423):1757-63. doi: 10.1016/S0140-6736(04)16300-9.

Reference Type BACKGROUND
PMID: 15172773 (View on PubMed)

Soehle M, Ellerkmann RK, Grube M, Kuech M, Wirz S, Hoeft A, Bruhn J. Comparison between bispectral index and patient state index as measures of the electroencephalographic effects of sevoflurane. Anesthesiology. 2008 Nov;109(5):799-805. doi: 10.1097/ALN.0b013e3181895fd0.

Reference Type BACKGROUND
PMID: 18946290 (View on PubMed)

Soehle M, Kuech M, Grube M, Wirz S, Kreuer S, Hoeft A, Bruhn J, Ellerkmann RK. Patient state index vs bispectral index as measures of the electroencephalographic effects of propofol. Br J Anaesth. 2010 Aug;105(2):172-8. doi: 10.1093/bja/aeq155. Epub 2010 Jun 29.

Reference Type BACKGROUND
PMID: 20587537 (View on PubMed)

Koch S, Stegherr AM, Morgeli R, Kramer S, Toubekis E, Lichtner G, von Dincklage F, Spies C. Electroencephalogram dynamics in children during different levels of anaesthetic depth. Clin Neurophysiol. 2017 Oct;128(10):2014-2021. doi: 10.1016/j.clinph.2017.07.417. Epub 2017 Aug 9.

Reference Type BACKGROUND
PMID: 28837907 (View on PubMed)

Tokuwaka J, Satsumae T, Mizutani T, Yamada K, Inomata S, Tanaka M. The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50 in children. Anaesthesia. 2015 Mar;70(3):318-22. doi: 10.1111/anae.12890. Epub 2014 Oct 1.

Reference Type BACKGROUND
PMID: 25271891 (View on PubMed)

Cornelissen L, Kim SE, Purdon PL, Brown EN, Berde CB. Age-dependent electroencephalogram (EEG) patterns during sevoflurane general anesthesia in infants. Elife. 2015 Jun 23;4:e06513. doi: 10.7554/eLife.06513.

Reference Type BACKGROUND
PMID: 26102526 (View on PubMed)

Kim J, Lee HC, Byun SH, Lim H, Lee M, Choung Y, Kim E. Frontal electroencephalogram activity during emergence from general anaesthesia in children with and without emergence delirium. Br J Anaesth. 2021 Jan;126(1):293-303. doi: 10.1016/j.bja.2020.07.060. Epub 2020 Oct 1.

Reference Type BACKGROUND
PMID: 33010926 (View on PubMed)

Eagleman SL, Drover CM, Li X, MacIver MB, Drover DR. Offline comparison of processed electroencephalogram monitors for anaesthetic-induced electroencephalogram changes in older adults. Br J Anaesth. 2021 May;126(5):975-984. doi: 10.1016/j.bja.2020.12.042. Epub 2021 Feb 25.

Reference Type BACKGROUND
PMID: 33640118 (View on PubMed)

Seo KH, Kim KM, Lee SK, John H, Lee J. Comparative Analysis of Phase Lag Entropy and Bispectral Index as Anesthetic Depth Indicators in Patients Undergoing Thyroid Surgery with Nerve Integrity Monitoring. J Korean Med Sci. 2019 May 27;34(20):e151. doi: 10.3346/jkms.2019.34.e151.

Reference Type BACKGROUND
PMID: 31124327 (View on PubMed)

Avidan MS, Zhang L, Burnside BA, Finkel KJ, Searleman AC, Selvidge JA, Saager L, Turner MS, Rao S, Bottros M, Hantler C, Jacobsohn E, Evers AS. Anesthesia awareness and the bispectral index. N Engl J Med. 2008 Mar 13;358(11):1097-108. doi: 10.1056/NEJMoa0707361.

Reference Type BACKGROUND
PMID: 18337600 (View on PubMed)

Katoh T, Kobayashi S, Suzuki A, Kato S, Iwamoto T, Bito H, Sato S. Fentanyl augments block of sympathetic responses to skin incision during sevoflurane anaesthesia in children. Br J Anaesth. 2000 Jan;84(1):63-6. doi: 10.1093/oxfordjournals.bja.a013384.

Reference Type BACKGROUND
PMID: 10740549 (View on PubMed)

Other Identifiers

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2109-164-1260

Identifier Type: -

Identifier Source: org_study_id

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