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首页> 美国卫生研究院文献>PLoS Clinical Trials >Different effects of propofol and dexmedetomidine sedation on electroencephalogram patterns: Wakefulness, moderate sedation, deep sedation and recovery
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Different effects of propofol and dexmedetomidine sedation on electroencephalogram patterns: Wakefulness, moderate sedation, deep sedation and recovery

机译：丙泊酚和右美托咪定镇静对脑电图模式的不同影响：清醒，中度镇静，深度镇静和恢复

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Sedation induces changes in electroencephalography (EEG) dynamics. However, the distinct EEG dynamic characteristics at comparable sedation levels have not been well studied, resulting in potential interpretation errors in EEG monitoring during sedation. We aimed to analyze the EEG dynamics of dexmedetomidine and propofol at comparable sedation levels and to explore EEG changes with increased sedation levels for each agent. We measured the Bispectral Index (BIS) and 20-channel EEG under dexmedetomidine and propofol sedation from wakefulness, moderate sedation, and deep sedation to recovery in healthy volunteers (n = 10) in a randomized, 2-day, crossover study. Observer’s Assessment of Alertness and Sedation (OAA/S) score was used to assess sedation levels. Despite similar changes in increased delta oscillations, multiple differences in the EEG spatiotemporal dynamics were observed between these two agents. During moderate sedation, both dexmedetomidine and propofol induced increased spindle power; however, dexmedetomidine decreased the global alpha/beta/gamma power, whereas propofol decreased the alpha power in the occipital area and increased the global spindle/beta/gamma power. During deep sedation, dexmedetomidine was associated with increased fronto-central spindle power and decreased global alpha/beta/gamma power, but propofol was associated with increased theta/alpha/spindle/beta power, which was maximized in the frontal area. The transition of topographic alpha/spindle/beta power distribution from moderate sedation to deep sedation completely differed between these two agents. Our study demonstrated that there was a distinct hierarchy of EEG changes with increased sedation depths by propofol and dexmedetomidine. Differences in EEG dynamics at the same sedation level might account for differences in the BIS value and reflect the different sedation mechanisms. EEG-based clinical sedation monitoring should consider the effect of drug types on EEG dynamics.
机译：镇静会引起脑电图（EEG）动态变化。但是，尚未对相当的镇静水平下的独特脑电动力学特征进行深入研究，从而在镇静过程中导致脑电图监测中存在潜在的解释错误。我们旨在分析可比镇静水平下右美托咪定和丙泊酚的脑电图动力学，并探讨每种药物随镇静剂水平提高而脑电图的变化。在一项为期2天的随机交叉研究中，我们测量了右美托咪定和丙泊酚镇静情况下从清醒，中度镇静和深度镇静到健康志愿者（n = 10）的恢复情况下双光谱指数（BIS）和20通道脑电图。观察者的警觉性和镇静评估（OAA / S）分数用于评估镇静水平。尽管增加的三角波振荡有相似的变化，但在这两种因子之间仍观察到脑电时空动力学的多个差异。在中等程度的镇静过程中，右美托咪定和丙泊酚均引起纺锤体功率增加。然而，右美托咪定降低了总体α/β/γ功率，而丙泊酚降低了枕骨区域的α功率并增加了总纺锤/β/γ功率。在深层镇静过程中，右美托咪定与额中中心纺锤度升高和总体α/β/γ散射度降低相关，而丙泊酚与θ/α/纺锤体/β散射度升高相关，后者在额叶区域最大。这两种药物之间的地形α/纺锤体/β功率分布从中度镇静到深度镇静的转变完全不同。我们的研究表明，丙泊酚和右美托咪定可增加镇静深度，导致脑电图变化明显。在相同的镇静水平下，脑电动力学的差异可能会解释BIS值的差异，并反映出不同的镇静机制。基于EEG的临床镇静监测应考虑药物类型对EEG动态的影响。

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