Investigation of Slow-wave Activity Saturation during Surgical Anesthesia Reveals a Signature of Neural Inertia in Humans.

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dc.contributor.author Warnaby, Catherine E en
dc.contributor.author Sleigh, James en
dc.contributor.author Hight, Darren en
dc.contributor.author Jbabdi, Saad en
dc.contributor.author Tracey, Irene en
dc.date.accessioned 2018-10-16T20:10:38Z en
dc.date.issued 2017-10 en
dc.identifier.issn 0003-3022 en
dc.identifier.uri http://hdl.handle.net/2292/42019 en
dc.description.abstract BACKGROUND:Previously, we showed experimentally that saturation of slow-wave activity provides a potentially individualized neurophysiologic endpoint for perception loss during anesthesia. Furthermore, it is clear that induction and emergence from anesthesia are not symmetrically reversible processes. The observed hysteresis is potentially underpinned by a neural inertia mechanism as proposed in animal studies. METHODS:In an advanced secondary analysis of 393 individual electroencephalographic data sets, we used slow-wave activity dose-response relationships to parameterize slow-wave activity saturation during induction and emergence from surgical anesthesia. We determined whether neural inertia exists in humans by comparing slow-wave activity dose responses on induction and emergence. RESULTS:Slow-wave activity saturation occurs for different anesthetics and when opioids and muscle relaxants are used during surgery. There was wide interpatient variability in the hypnotic concentrations required to achieve slow-wave activity saturation. Age negatively correlated with power at slow-wave activity saturation. On emergence, we observed abrupt decreases in slow-wave activity dose responses coincident with recovery of behavioral responsiveness in ~33% individuals. These patients are more likely to have lower power at slow-wave activity saturation, be older, and suffer from short-term confusion on emergence. CONCLUSIONS:Slow-wave activity saturation during surgical anesthesia implies that large variability in dosing is required to achieve a targeted potential loss of perception in individual patients. A signature for neural inertia in humans is the maintenance of slow-wave activity even in the presence of very-low hypnotic concentrations during emergence from anesthesia. en
dc.format.medium Print en
dc.language eng en
dc.relation.ispartofseries Anesthesiology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.subject Brain en
dc.subject Humans en
dc.subject Anesthetics en
dc.subject Electroencephalography en
dc.subject Age Factors en
dc.subject Dose-Response Relationship, Drug en
dc.subject Adolescent en
dc.subject Adult en
dc.subject Aged en
dc.subject Aged, 80 and over en
dc.subject Middle Aged en
dc.subject Female en
dc.subject Male en
dc.subject Young Adult en
dc.title Investigation of Slow-wave Activity Saturation during Surgical Anesthesia Reveals a Signature of Neural Inertia in Humans. en
dc.type Journal Article en
dc.identifier.doi 10.1097/aln.0000000000001759 en
pubs.issue 4 en
pubs.begin-page 645 en
pubs.volume 127 en
dc.rights.holder Copyright: The author en
dc.identifier.pmid 28665814 en
pubs.end-page 657 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Journal Article en
pubs.elements-id 636088 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Anaesthesiology en
dc.identifier.eissn 1528-1175 en
pubs.record-created-at-source-date 2017-07-01 en
pubs.dimensions-id 28665814 en


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