Mason Keira P, O'Mahony Elizabeth, Zurakowski David, Libenson Mark H
Departments of Anesthesia, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
Paediatr Anaesth. 2009 Dec;19(12):1175-83. doi: 10.1111/j.1460-9592.2009.03160.x.
To examine the effects of dexmedetomidine sedation on EEG background and epileptiform activity in children, comparing it to natural sleep.
To provide quantitative and qualitative descriptions of the effect of dexmedetomidine sedation on the EEG of children.
Children with intractable epilepsy admitted for surgery undergo 5 days of continuous EEG monitoring as well as nuclear medicine imaging studies with dexmedetomidine for sedation. Continuous EEG monitoring of each child during both natural sleep and dexmedetomidine-induced sedation provides a unique opportunity to evaluate the effects of dexmedetomidine on the EEG of children.
MATERIALS/METHODS: Sixteen children undergoing dexmedetomidine sedation for nuclear medicine studies and simultaneous continuous EEG monitoring were studied. EEG segments during sedation were compared to samples of naturally occurring stage II sleep from the same child. Standard visual EEG analysis, quantification of delta, theta, alpha, beta, and total RMS power, number and location of spike foci, and frequency of spike activity were compared.
The EEG during dexmedetomidine sedation resembled stage II sleep. During sedation, statistically significant increases in power of 16% for theta (P = 0.01), 21% for alpha (P = 0.03), and 40% for beta (P < 0.01) were observed, but not for delta (P = 0.63) or total EEG power (P = 0.61). Spike frequency increased by 47% during sedation but no new spike foci or seizures were observed.
Dexmedetomidine sedation elicited an EEG pattern similar to that of Stage II sleep with modest increases in theta, alpha, and beta activity. Dexmedetomidine does not hinder interpretation of the EEG, suggesting that it may be a uniquely useful agent for EEG sedation in children.
研究右美托咪定镇静对儿童脑电图背景及癫痫样活动的影响，并与自然睡眠进行比较。
对右美托咪定镇静对儿童脑电图的影响进行定量和定性描述。
因顽固性癫痫入院接受手术的儿童在手术前需进行5天的连续脑电图监测，并使用右美托咪定进行核医学成像检查时的镇静。对每个儿童在自然睡眠和右美托咪定诱导的镇静过程中进行连续脑电图监测，为评估右美托咪定对儿童脑电图的影响提供了独特的机会。
材料/方法：对16名接受右美托咪定镇静进行核医学检查并同时进行连续脑电图监测的儿童进行研究。将镇静期间的脑电图片段与同一儿童自然发生的II期睡眠样本进行比较。比较标准的视觉脑电图分析、δ波、θ波、α波、β波和总均方根功率的量化、棘波灶的数量和位置以及棘波活动的频率。
右美托咪定镇静期间的脑电图类似于II期睡眠。在镇静期间，观察到θ波功率有统计学意义的增加，增加了16%（P = 0.01），α波增加了21%（P = 0.03），β波增加了40%（P < 0.01），但δ波（P = 0.63）或总脑电图功率（P = 0.61）没有增加。镇静期间棘波频率增加了47%，但未观察到新的棘波灶或癫痫发作。
右美托咪定镇静引起的脑电图模式类似于II期睡眠，θ波、α波和β波活动略有增加。右美托咪定不妨碍脑电图的解读，表明它可能是儿童脑电图镇静的一种特别有用的药物。
