1 Department of Intensive Care Medicine and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
2 Department of Psychiatry and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Clin EEG Neurosci. 2019 Nov;50(6):436-443. doi: 10.1177/1550059419838938. Epub 2019 May 20.
. Despite widespread application, little is known about the neurophysiological effects of light sedation with midazolam or propofol, particularly in older subjects. The aim of this study was to assess the effects of light sedation with midazolam or propofol on a variety of EEG measures in older subjects. . In patients (≥60 years without neuropsychiatric disease such as delirium), 2 EEG recordings were performed, before and after administration of either midazolam (n = 22) or propofol (n = 26) to facilitate an endoscopic procedure. Power spectrum, functional connectivity, and network topology based on the minimum spanning tree (MST) were compared within subjects. . Midazolam and propofol administration resulted in Richmond Agitation and Sedation Scale levels between 0 and -4 and between -2 and -4, respectively. Both agents altered the power spectra with increased delta (0.5-4 Hz) and decreased alpha (8-13 Hz) power. Only propofol was found to significantly reduce functional connectivity. In the beta frequency band, the MST was more integrated during midazolam sedation. Propofol sedation resulted in a less integrated network in the alpha frequency band. . Despite the different levels of light sedation with midazolam and propofol, similar changes in power were found. Functional connectivity and network topology showed differences between midazolam and propofol sedation. Future research should establish if these differences are caused by the different levels of sedation or the mechanism of action of these agents.
. 尽管咪达唑仑和丙泊酚镇静在临床上广泛应用，但人们对其神经生理效应，尤其是在老年患者中的神经生理效应知之甚少。本研究旨在评估咪达唑仑和丙泊酚镇静对老年患者多种脑电图测量指标的影响。. 在患者（≥60 岁，无谵妄等神经精神疾病）中，为便于进行内镜检查，分别给予咪达唑仑（n = 22）或丙泊酚（n = 26），并在给药前后进行 2 次脑电图记录。在患者间进行基于最小生成树（MST）的功率谱、功能连接和网络拓扑比较。. 咪达唑仑和丙泊酚给药后，Richmond 躁动镇静量表评分为 0-4 分和-2-4 分。两种药物均改变了功率谱，增加了 delta（0.5-4 Hz）波，减少了 alpha（8-13 Hz）波。只有丙泊酚显著降低了功能连接。在β频带中，咪达唑仑镇静时 MST 更为整合。丙泊酚镇静导致 alpha 频带的网络整合度降低。. 尽管咪达唑仑和丙泊酚镇静的程度不同，但发现了相似的功率变化。功能连接和网络拓扑显示了咪达唑仑和丙泊酚镇静之间的差异。未来的研究应确定这些差异是由镇静程度的不同还是这些药物的作用机制引起的。
