Zhang Mae, Mather Rory Vu, Chung Ashley R, Leung Chee Fai Andy, Ramamurthi Radhamangalam J, Purdon Patrick L
From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.
Harvard/MIT MD-PhD Program, Boston, Massachusetts.
A A Pract. 2025 Jan 20;19(1):e01910. doi: 10.1213/XAA.0000000000001910. eCollection 2025 Jan 1.
In this case, the electroencephalogram (EEG) was used to guide anesthesia care for a pediatric patient with Alexander's Disease undergoing serial intrathecal injections. Previous procedures using a standard maintenance propofol dose of up to 225 µg/kg/min led to postanesthetic recovery times of over 6 hours, requiring a neurology consult for noncoherence. The EEG assisted in guiding maintenance propofol dosing to 75 µg/kg/min, decreasing postanesthetic wash-off and postanesthesia care unit (PACU) recovery time by 50%. This highlights the potential impact of astrocyte dysfunction on anesthetic sensitivity and robustness of EEG as a biomarker of anesthetic effect, including for pediatric patients with rare neurodevelopmental diseases.
在该病例中，脑电图（EEG）被用于指导一名患有亚历山大病的儿科患者在进行连续鞘内注射时的麻醉护理。之前使用高达225µg/kg/min的标准丙泊酚维持剂量的操作导致麻醉后恢复时间超过6小时，因患者意识不清而需要神经科会诊。脑电图有助于将丙泊酚维持剂量调整至75µg/kg/min，使麻醉后药物清除时间和麻醉后护理单元（PACU）恢复时间缩短了50%。这凸显了星形胶质细胞功能障碍对麻醉敏感性的潜在影响，以及脑电图作为麻醉效果生物标志物的稳健性，包括对患有罕见神经发育疾病的儿科患者。
