S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) Theses (Master's Degree_의학과)
The efficacy of intraoperative EEG to predict the occurrence of emergence agitation after sevoflurane anesthesia in children
세보플루레인 마취 후 각성 발작의 예측 인자로서의 수술 중 뇌파 검사의 유용성
- 의과대학 의학과
- Issue Date
- 서울대학교 대학원
- 학위논문 (석사)-- 서울대학교 대학원 : 의학과(마취통증의학과), 2013. 8. 김희수.
- Introduction: Emergence agitation (EA) is common after sevoflurane anesthesia in children, but its appearance cannot be predicted. We investigated whether the intraoperative EEG during sevoflurane anesthesia can indicate the occurrence or degree of EA in children.
Methods: EEG-derived parameters (SEF95, beta, alpha, theta, and delta power) were measured at 2.0 vol% (during the maintenance of anesthesia) and 0.7 vol% (during emergence) end-tidal sevoflurane (EtSEVO) anesthesia in 29 pediatric patients (aged from 1 to 6 years). EA was evaluated using the emergence agitation score (EAS
1-5) at the post-anesthetic care unit (PACU) on arrival (EAS 0) and at 15 and 30 minutes after the arrival (EAS 15 and EAS 30). The correlation between EEG-derived parameters and EA score was analyzed using Spearman correlation, and receiver operating characteristic (ROC) curve analysis was used to measure the predictability.
Results: EA occurred in 11 patients. The alpha power at 0.7 vol% of EtSEVO was positively correlated with EAS 15 and EAS 30 (Spearman correlation coefficient
0.392 and 0.566, p = 0.035 and 0.001, respectively). The theta/alpha ratio at 0.7 vol% of EtSEVO was negatively correlated with EAS 30 (Spearman correlation coefficient
-0.478, p = 0.009). There were no significant differences in SEF95 at 2.0 vol% and 0.7 vol% of EtSEVO between patients with EA and those who without EA. The area under the ROC curve of the percentage of alpha bands at 0.7 vol% of EtSEVO and the occurrence of EA was 0.672.
Conclusions: We conclude that children showing high alpha powers and low theta powers (= low theta/alpha ratio) during emergence from sevoflurane anesthesia are at high risk of EA in PACU. (cris.nih.go.kr number, KCT0000652)