Changes in the Term Neonatal Electroencephalogram with General Anesthesia: A Systematic Review with Narrative Synthesis.

IF 9.1 1区医学 Q1 ANESTHESIOLOGY Anesthesiology Pub Date : 2024-10-01 DOI:10.1097/ALN.0000000000005088

Sebastian J Corlette, Suellen M Walker, Laura Cornelissen, Christopher Brasher, Janeen Bower, Andrew J Davidson

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Abstract

Background: Although effects of general anesthesia on neuronal activity in the human neonatal brain are incompletely understood, electroencephalography provides some insight and may identify age-dependent differences.

Methods: A systematic search (MEDLINE, Embase, PubMed, and Cochrane Library to November 2023) retrieved English language publications reporting electroencephalography during general anesthesia for cardiac or noncardiac surgery in term neonates (37 to 44 weeks postmenstrual age). Data were extracted, and risk of bias (ROBINS-I Cochrane tool) and quality of evidence (Grading of Recommendations Assessment, Development, and Evaluation [GRADE] checklist) were assessed.

Results: From 1,155 abstracts, 9 publications (140 neonates; 55% male) fulfilled eligibility criteria. Data were limited, and study quality was very low. The occurrence of discontinuity, a characteristic pattern of alternating higher and lower amplitude electroencephalography segments, was reported with general anesthesia (94 of 119 neonates, 6 publications) and with hypothermia (23 of 23 neonates, 2 publications). Decreased power in the delta (0.5 to 4 Hz) frequency range was also reported with increasing anesthetic dose (22 neonates; 3 publications).

Conclusion: Although evidence gaps were identified, both increasing sevoflurane concentration and decreasing temperature are associated with increasing discontinuity.

Editor’s perspective:

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全身麻醉对新生儿期脑电图的影响--系统综述。

虽然人们对全身麻醉对新生儿大脑神经元活动的影响尚不完全了解，但脑电图（EEG）提供了一些见解，并可识别与年龄有关的差异。通过系统性检索（MEDLINE、Embase、PUBMED、Cochrane 图书馆，截至 2023 年 11 月），检索到了报道足月新生儿（月经后 37 至 44 周）在心脏或非心脏手术全身麻醉期间脑电图的英文出版物。提取数据并评估偏倚风险（ROBINS-I Cochrane 工具）和证据质量（GRADE 检查表）。从 1155 篇摘要中，有 9 篇（157 名新生儿；55.7% 为男性）符合资格标准。数据有限，研究质量很低。据报道，在全身麻醉（119 名新生儿中的 94 名，6 篇文献）和低体温（23 名新生儿中的 23 名，2 篇文献）时，会出现不连续性，即振幅较高和较低的脑电图片段交替出现的特征模式。随着麻醉剂量的增加，δ（0.5-4Hz）频率范围的功率也有下降的报道（39 例新生儿；3 篇文献）。虽然发现了证据缺口，但七氟烷浓度增加和体温降低都与不连续性增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anesthesiology 医学-麻醉学

CiteScore

10.40

自引率

5.70%

发文量

542

审稿时长

3-6 weeks

期刊介绍： With its establishment in 1940, Anesthesiology has emerged as a prominent leader in the field of anesthesiology, encompassing perioperative, critical care, and pain medicine. As the esteemed journal of the American Society of Anesthesiologists, Anesthesiology operates independently with full editorial freedom. Its distinguished Editorial Board, comprising renowned professionals from across the globe, drives the advancement of the specialty by presenting innovative research through immediate open access to select articles and granting free access to all published articles after a six-month period. Furthermore, Anesthesiology actively promotes groundbreaking studies through an influential press release program. The journal's unwavering commitment lies in the dissemination of exemplary work that enhances clinical practice and revolutionizes the practice of medicine within our discipline.