Evidence of auditory processing during postoperative propofol sedation

Yppärilä, Heidi; Karhu, Jari; Westerén-Punnonen, Susanna; Musialowicz, Tadeusz; Partanen, Juhani

doi:10.1016/s1388-2457(02)00158-x

Cited by 32 publications

(21 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The MMN was clearly reduced compared to the awake state. The presence of this MMN residual during deep sedation replicates findings from previous studies (Heinke et al, 2004b;Yppärilla et al, 2002), indicating that auditory sensory memory operations are markedly affected by sedation, but can still be observed under deep sedation, even when participants are unresponsive to normal verbal commands. Simpson et al (2002) reported that a frequency-MMN was visible in ERPs recorded during deep sedation, but statistically not significant.…”

Section: Deep Sedationsupporting

confidence: 86%

“…Studies investigating the effects of deep propofol sedation on the MMN (Heinke et al, 2004b;Simpson et al, 2002;Yppärilla et al, 2002) have not yet provided a consistent picture. Yppärilla et al (2002) showed an MMN in patients who did not respond to loud auditory stimuli or light tactile stimulation (Ramsey Score 6).…”

Section: Introductionmentioning

confidence: 99%

“…Yppärilla et al (2002) showed an MMN in patients who did not respond to loud auditory stimuli or light tactile stimulation (Ramsey Score 6). Simpson et al (2002) reported that MMN potentials observed in unresponsive subjects were statistically not significant, and MMN potentials elicited when subjects responded to commands were not consistent (a significant MMN was elicited by a frequency, but not by a duration deviance).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Auditory processing during deep propofol sedation and recovery from unconsciousness

Koelsch

Heinke²,

Sammler

et al. 2006

Clinical Neurophysiology

View full text Add to dashboard Cite

Objective: Using evoked potentials, this study investigated effects of deep propofol sedation, and effects of recovery from unconsciousness, on the processing of auditory information with stimuli suited to elicit a physical MMN, and a (music-syntactic) ERAN. Methods: Levels of sedation were assessed using the Bispectral Index (BIS) and the Modified Observer's Assessment of Alertness and Sedation Scale (MOAAS). EEG-measurements were performed during wakefulness, deep propofol sedation (MOAAS 2-3, mean BISZ68), and a recovery period. Between deep sedation and recovery period, the infusion rate of propofol was increased to achieve unconsciousness (MOAAS 0-1, mean BISZ35); EEG measurements of recovery period were performed after subjects regained consciousness. Results: During deep sedation, the physical MMN was markedly reduced, but still significant. No ERAN was observed in this level. A clear P3a was elicited during deep sedation by those deviants, which were task-relevant during the awake state. As soon as subjects regained consciousness during the recovery period, a normal MMN was elicited. By contrast, the P3a was absent in the recovery period, and the P3b was markedly reduced. Conclusions: Results indicate that the auditory sensory memory (as indexed by the physical MMN) is still active, although strongly reduced, during deep sedation (MOAAS 2-3). The presence of the P3a indicates that attention-related processes are still operating during this level. Processes of syntactic analysis appear to be abolished during deep sedation. After propofol-induced anesthesia, the auditory sensory memory appears to operate normal as soon as subjects regain consciousness, whereas the attention-related processes indexed by P3a and P3b are markedly impaired. Significance: Results inform about effects of sedative drugs on auditory and attention-related mechanisms. The findings are important because these mechanisms are prerequisites for auditory awareness, auditory learning and memory, as well as language perception during anesthesia.

show abstract

Section: Deep Sedationsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Auditory processing during deep propofol sedation and recovery from unconsciousness

Koelsch

Heinke²,

Sammler

et al. 2006

Clinical Neurophysiology

View full text Add to dashboard Cite

show abstract

“…Our group failed to identify a P3 response to the own name during profound general anesthesia using propofol and remifentanil. Some authors, however, using an auditory oddball paradigm (employing sounds not the subjects' own name) demonstrated a P3 response in pharmacological coma (Jessop et al, 1991;Reinsel, Veselis, Wronski, & Marino, 1995;Sneyd et al, 1994;Ypparila, Karhu, Westeren-Punnonen, Musialowicz, & Partanen, 2002)-but others failed to confirm these results (Plourde & Boylan, 1991;van Hooff, de Beer, Brunia, Cluitmans, & Korsten, 1997;Van Hooff et al, 1995). Also in pathological coma a P3 can sometimes be observed and has been proposed by limited series to herald some prognostic value (Gott, Rabinowicz, & DeGiorgio, 1991;Mutschler et al, 1996;Signorino, D'Acunto, Angeleri, & Pietropaoli, 1995).…”

Section: Sleep and The Vegetative Statementioning

confidence: 99%

Functional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient

Boly¹,

Tshibanda²,

Vanhaudenhuyse³

et al. 2009

Human Brain Mapping

301

216

View full text Add to dashboard Cite

The clinical and para-clinical examination of residual self-consciousness in non-communicative severely brain damaged patients (i.e., coma, vegetative state and minimally conscious state) remains exceptionally challenging. Passive presentation of the patient's own name and own face are known to be effective attention-grabbing stimuli when clinically assessing consciousness at the patient's bedside. Event-related potential and functional neuroimaging studies using such self-referential stimuli are currently being used to disentangle the cognitive hierarchy of self-processing. We here review neuropsychological, neuropathological, electrophysiological and neuroimaging studies using the own name and own face paradigm obtained in conscious waking, sleep, pharmacological coma, pathological coma and related disorders of consciousness. Based on these results we discuss what we currently do and do not know about the functional significance of the neural network involved in ''automatic'' and ''conscious'' self-referential processing.

show abstract

“…ERPs have exhibited graded changes with increasing doses of sedative drugs in volunteers and surgical patients [6,7], but to date only few data are available concerning the use of ERPs for monitoring sedation level in the ICU. Despite the known superiority of ERP parameters over EEG parameters for monitoring sedation level, in this preliminary pilot study we hypothesized that both ERPs and EEG may be used to assess the level of sedation in a heterogeneous group of neurologically intact intensive care patients.…”

Section: Introductionmentioning

confidence: 99%

The effect of interruption to propofol sedation on auditory event-related potentials and electroencephalogram in intensive care patients

et al. 2004

Self Cite

View full text Add to dashboard Cite

Introduction In this observational pilot study we evaluated the electroencephalogram (EEG) and auditory event-related potentials (ERPs) before and after discontinuation of propofol sedation in neurologically intact intensive care patients. Methods Nineteen intensive care unit patients received a propofol infusion in accordance with a sedation protocol. The EEG signal and the ERPs were measured at the frontal region (Fz) and central region (Cz), both during propofol sedation and after cessation of infusion when the sedative effects had subsided. The EEG signal was subjected to power spectral estimation, and the total root mean squared power and spectral edge frequency 95% were computed. For ERPs, we used an oddball paradigm to obtain the N100 and the mismatch negativity components. Results Despite considerable individual variability, the root mean squared power at Cz and Fz (P = 0.004 and P = 0.005, respectively) and the amplitude of the N100 component in response to the standard stimulus at Fz (P = 0.022) increased significantly after interruption to sedation. The amplitude of the N100 component (at Cz and Fz) was the only parameter that differed between sedation levels during propofol sedation (deep versus moderate versus light sedation: P = 0.016 and P = 0.008 for Cz and Fz, respectively). None of the computed parameters correlated with duration of propofol infusion. Conclusion Our findings suggest that use of ERPs, especially the N100 potential, may help to differentiate between levels of sedation. Thus, they may represent a useful complement to clinical sedation scales in the monitoring of sedation status over time in a heterogeneous group of neurologically intact intensive care patients.

show abstract

Evidence of auditory processing during postoperative propofol sedation

Cited by 32 publications

References 26 publications

Auditory processing during deep propofol sedation and recovery from unconsciousness

Auditory processing during deep propofol sedation and recovery from unconsciousness

Functional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient

The effect of interruption to propofol sedation on auditory event-related potentials and electroencephalogram in intensive care patients

Contact Info

Product

Resources

About