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Differentiating Drug-related and State-related Effects of Dexmedetomidine and Propofol on the Electroencephalogram
University of Turku, Finland / Hospital District of Southwest Finland, Turku, Finland / Turku University Hospital, Finland.
Turku University Hospital, Finland / University of Turku, Finland.
University of Michigan Medical School, Ann Arbor, Michigan.
Turku University Hospital, Finland.
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2018 (English)In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 129, no 1, p. 22-36Article in journal (Refereed) Published
Abstract [en]

BACKGROUND

Differentiating drug-related changes and state-related changes on the electroencephalogram during anesthetic-induced unconsciousness has remained a challenge. To distinguish these, we designed a rigorous experimental protocol with two drugs known to have distinct molecular mechanisms of action. We hypothesized that drug- and state-related changes can be separated.

METHODS: 

Forty-seven healthy participants were randomized to receive dexmedetomidine (n = 23) or propofol (n = 24) as target-controlled infusions until loss of responsiveness. Then, an attempt was made to arouse the participant to regain responsiveness while keeping the drug infusion constant. Finally, the concentration was increased 1.5-fold to achieve presumable loss of consciousness. We conducted statistical comparisons between the drugs and different states of consciousness for spectral bandwidths, and observed how drug-induced electroencephalogram patterns reversed upon awakening. Cross-frequency coupling was also analyzed between slow-wave phase and alpha power.

RESULTS: 

Eighteen (78%) and 10 (42%) subjects were arousable during the constant drug infusion in the dexmedetomidine and propofol groups, respectively (P = 0.011 between the drugs). Corresponding with deepening anesthetic level, slow-wave power increased, and a state-dependent alpha anteriorization was detected with both drugs, especially with propofol. Negative phase-amplitude coupling before and during loss of responsiveness frontally and positive coupling during the highest drug concentration posteriorly were observed in the propofol but not in the dexmedetomidine group.

CONCLUSIONS: 

Electroencephalogram effects of dexmedetomidine and propofol are strongly drug- and state-dependent. Changes in slow-wave and alpha activity seemed to best detect different states of consciousness.

Place, publisher, year, edition, pages
2018. Vol. 129, no 1, p. 22-36
National Category
Biological Sciences
Research subject
Consciousness and Cognitive Neuroscience
Identifiers
URN: urn:nbn:se:his:diva-15616DOI: 10.1097/ALN.0000000000002192ISI: 000435563800006PubMedID: 29642080Scopus ID: 2-s2.0-85048814054OAI: oai:DiVA.org:his-15616DiVA, id: diva2:1219087
Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2019-09-04Bibliographically approved

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Valli, KatjaRevonsuo, Antti

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