Effect of sedation and analgesia on postoperative amplitude-integrated EEG in newborn cardiac patients.
Pediatr Res
; 67(6): 650-5, 2010 Jun.
Article
em En
| MEDLINE
| ID: mdl-20496474
ABSTRACT
The aim of this study is to describe the effect of sedation and analgesia on postoperative amplitude-integrated EEG (aEEG) in newborns with congenital heart disease (CHD) undergoing heart surgery. This is a consecutive series of 26 newborns with CHD of which 16 patients underwent cardiopulmonary bypass (CPB) surgery and 10 patients did not. aEEG was monitored for at least 12 h preoperatively and started within the first 6 h postoperatively for 48 h. Outcome was assessed at 1 year of age. All 26 patients showed a normal preoperative continuous cerebral activity with sleep-wake cycles (SWC). The postoperative duration to return to normal background activity with SWC was similar for both groups. Independent of group assignment, patients requiring midazolam had a significantly later onset of a normal SWC than those without midazolam (p=0.03). Three patients in the CPB group and two in the non-CPB group showed continuous low voltage or flat trace after administration of fentanyl. These changes did not correlate with neurodevelopmental outcome. Sedation with midazolam has a transient effect on the background activity, whereas fentanyl can induce a severe pathologic background pattern. The significance of these changes on outcome is not yet clear. Thus, more attention should be paid to these effects when interpreting aEEG in this population.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Midazolam
/
Encéfalo
/
Fentanila
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Eletroencefalografia
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Cardiopatias Congênitas
/
Procedimentos Cirúrgicos Cardíacos
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Analgésicos Opioides
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Hipnóticos e Sedativos
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Morfina
Limite:
Humans
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Infant
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Newborn
Idioma:
En
Revista:
Pediatr Res
Ano de publicação:
2010
Tipo de documento:
Article