Influence of Antiepileptic Drugs on Amplitude-Integrated Electroencephalography

Shany, Eilon; Benzaquen, Oshra; Friger, Michael; Richardson, Justin; Golan, Agneta

doi:10.1016/j.pediatrneurol.2008.08.005

Cited by 36 publications

(12 citation statements)

References 22 publications

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“…49 Midazolam is another medication frequently used in cases of HIE and it appears that when administered in moderate doses, midazolam does not affect EEG activity. 49 It has also been shown that the median time-to-recovery of electrocortical background activity following the administration of anesthetic or antiepileptic medication in term infants, is 2.5 h, with a range of 2 to 15 h. 50 A previous investigation of the effects of anesthetic drugs on neurovascular coupling mechanisms showed, in general, that the effects are similar across different medications. 51 A recent study of the influence of TH on cortico-vascular activity examined cerebral oxygen metabolism, cerebral blood flow, and blood volume in HIE infants during TH, using frequency domain NIRS and diffuse correlation spectroscopy.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy

et al. 2016

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Abstract. Burst suppression (BS) is an electroencephalographic state associated with a profound inactivation of the brain. BS and pathological discontinuous electroencephalography (EEG) are often observed in term-age infants with neurological injury and can be indicative of a poor outcome and lifelong disability. Little is known about the neurophysiological mechanisms of BS or how the condition relates to the functional state of the neonatal brain. We used simultaneous EEG and diffuse optical tomography (DOT) to investigate whether bursts of EEG activity in infants with hypoxic ischemic encephalopathy are associated with an observable cerebral hemodynamic response. We were able to identify significant changes in concentration of both oxy and deoxyhemoglobin that are temporally correlated with EEG bursts and present a relatively consistent morphology across six infants. Furthermore, DOT reveals patient-specific spatial distributions of this hemodynamic response that may be indicative of a complex pattern of cortical activation underlying discontinuous EEG activity that is not readily apparent in scalp EEG.

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Section: Discussionmentioning

confidence: 99%

Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy

et al. 2016

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“…In our cohort, plasma glucose concentration did not change significantly during hypercapnia. It is well known that medication such as morphine and benzodiazepines, which are often used in infants admitted to the NICU for sedation or as antiepileptic drugs, can suppress the EEG 19 20. The use of sedatives was unlikely to have caused the sudden depression in the aEEG in our cohort because almost all infants were already receiving sedatives for several hours or even days.…”

Section: Discussionmentioning

confidence: 82%

Severe hypercapnia causes reversible depression of aEEG background activity in neonates: an observational study

Weeke

Dix

Groenendaal

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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“…Ngyuen et al [7] showed that sufentanil had an effect on the EEG background in preterm newborns with increased discontinuity in those with higher doses of sufentanil; however, SWC was preserved. Excessive EEG discontinuity has also been reported after continuous morphine infusion in preterm infants 1 30 weeks' gestational age [10] and after continuous midazolam administration [24] . This abnormality has persisted during maintenance therapy [23] .…”

Section: Discussionmentioning

confidence: 88%

Effects of Morphine and Midazolam on Sleep-Wake Cycling in Amplitude-Integrated Electroencephalography in Post-Surgical Neonates ≥32 Weeks of Gestational Age

et al. 2012

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Background: Studies of children who undergo major non-cardiac surgery in the neonatal period are needed so that subsequent abnormal neurodevelopment can be better understood. Objective:It was the aim of our study to describe the influence of analgesic and sedative medication on the predominant background pattern and the development of sleep-wake cycling (SWC), as measured on amplitude-integrated electroencephalography (aEEG), in newborn infants born ≥32 weeks’ gestation after major non-cardiac surgery. Methods:This prospective study included infants ≥32⁺⁰ weeks’ gestation admitted to the Neonatal Intensive Care Unit at The Royal Children’s Hospital in Melbourne who were undergoing major non-cardiac surgery. Data on morphine and midazolam given after surgery were recorded and the BrainZ Monitor was applied post-operatively. The maximum levels of morphine and midazolam were assessed as predictors of time to aEEG outcomes using linear regression. Results: Forty-seven eligible infants were included. Emergence of SWC was observed at a mean of 13 h after surgery. The maximum dose of morphine or midazolam was not predictive of time to either any or developed SWC. Conclusions: Despite high doses of morphine and midazolam, SWC was observed on aEEG in neonates ≥32 weeks’ gestational age soon after major non-cardiac surgery. The aEEG background pattern was not affected by the maximum dose of either morphine or midazolam.

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Influence of Antiepileptic Drugs on Amplitude-Integrated Electroencephalography

Cited by 36 publications

References 22 publications

Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy

Hemodynamic response to burst-suppressed and discontinuous electroencephalography activity in infants with hypoxic ischemic encephalopathy

Severe hypercapnia causes reversible depression of aEEG background activity in neonates: an observational study

Effects of Morphine and Midazolam on Sleep-Wake Cycling in Amplitude-Integrated Electroencephalography in Post-Surgical Neonates ≥32 Weeks of Gestational Age

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