dc.contributor.author |
Gaskell, Amy |
en |
dc.contributor.author |
Hight, DF |
en |
dc.contributor.author |
Winders, J |
en |
dc.contributor.author |
Tran, G |
en |
dc.contributor.author |
Defresne, A |
en |
dc.contributor.author |
Bonhomme, V |
en |
dc.contributor.author |
Raz, A |
en |
dc.contributor.author |
Sleigh, James |
en |
dc.contributor.author |
Sanders, RD |
en |
dc.date.accessioned |
2018-11-06T21:30:58Z |
en |
dc.date.issued |
2017-10 |
en |
dc.identifier.issn |
0007-0912 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/44032 |
en |
dc.description.abstract |
Background:The isolated forearm test (IFT) is the gold standard test of connected consciousness (awareness of the environment) during anaesthesia. The frontal alpha-delta EEG pattern (seen in slow wave sleep) is widely held to indicate anaesthetic-induced unconsciousness. A priori we proposed that one responder with the frontal alpha-delta EEG pattern would falsify this concept. Methods:Frontal EEG was recorded in a subset of patients from three centres participating in an international multicentre study of IFT responsiveness following tracheal intubation. Raw EEG waveforms were analysed for power-frequency spectra, depth-of-anaesthesia indices, permutation entropy, slow wave activity saturation and alpha-delta amplitude-phase coupling. Results:Volitional responses to verbal command occurred in six out of 90 patients. Three responses occurred immediately following intubation in patients (from Sites 1 and 2) exhibiting an alpha-delta dominant (delta power >20 dB, alpha power >10 dB) EEG pattern. The power-frequency spectra obtained during these responses were similar to those of non-responders (P>0.05) at those sites. A further three responses occurred in (Site 3) patients not exhibiting the classic alpha-delta EEG pattern; these responses occurred later relative to intubation, and in patients had been co-administered ketamine and less volatile anaesthetic compared with Site 1 and 2 patients. None of the derived depth-of-anaesthesia indices could robustly discrimate IFT responders and non-responders. Conclusions:Connected consciousness can occur in the presence of the frontal alpha-delta EEG pattern during anaesthesia. Frontal EEG parameters do not readily discriminate volitional responsiveness (a marker of connected consciousness) and unresponsiveness during anaesthesia. Clinical trial registration:NCT02248623. |
en |
dc.format.medium |
Print |
en |
dc.language |
eng |
en |
dc.relation.ispartofseries |
BJA: British Journal of Anaesthesia |
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 |
Forearm |
en |
dc.subject |
Humans |
en |
dc.subject |
Electroencephalography |
en |
dc.subject |
Monitoring, Intraoperative |
en |
dc.subject |
Anesthesia, General |
en |
dc.subject |
Cohort Studies |
en |
dc.subject |
Prospective Studies |
en |
dc.subject |
Consciousness |
en |
dc.subject |
Adult |
en |
dc.subject |
Female |
en |
dc.subject |
Male |
en |
dc.subject |
Young Adult |
en |
dc.title |
Frontal alpha-delta EEG does not preclude volitional response during anaesthesia: prospective cohort study of the isolated forearm technique. |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1093/bja/aex170 |
en |
pubs.issue |
4 |
en |
pubs.begin-page |
664 |
en |
pubs.volume |
119 |
en |
dc.rights.holder |
Copyright: The author |
en |
dc.identifier.pmid |
29121278 |
en |
pubs.end-page |
673 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Multicenter Study |
en |
pubs.subtype |
Journal Article |
en |
pubs.elements-id |
666552 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Anaesthesiology |
en |
dc.identifier.eissn |
1471-6771 |
en |
pubs.record-created-at-source-date |
2017-11-10 |
en |
pubs.dimensions-id |
29121278 |
en |