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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
Lippincott Williams & Wilkins, 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
Note

Copyright © 2018, the American Society of Anesthesiologists, Inc. Wolters Kluwer Health, Inc. All Rights Reserved. The RightsLink Digital Licensing and Rights Management Service (including RightsLink for Open Access) is available (A) to users of copyrighted works found at the websites of participating publishers who are seeking permissions or licenses to use those works, and (B) to authors of articles and other manuscripts who are seeking to pay author publication charges in connection with the submission of their works to publishers. 

Available from: 2018-06-15 Created: 2018-06-15 Last updated: 2021-01-07Bibliographically approved

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Valli, KatjaRevonsuo, Antti

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