Application of quantitative EEG in sedation depth monitoring after traumatic brain injure operation / 中华创伤杂志

ABSTRACT

Objective To observe the dynamic changes of the power parameters of each frequency band of electroencephalography during the postoperative sedation process of traumatic brain injuries (TBI) to evaluate the values of EEG power in assessing sedation depth.Methods A retrospective case series study was conducted on the clinical postoperative data of 42 patients with TBI from February 2017 to January 2018.There were 22 males and 20 females,aged (39.8 ± 5.3)years (range,25-66 years).Before the sedation,the Glasgow Coma Scale (GCS) was (9.2 ± 2.3)points,ranging from 8 to 12 points.Before the administration of dexmedetomidine (Dex) and 10,30,60,90 minutes after the medication,the body temperature,respiration,heart rate,oxygen saturation (SpO2),and mean arterial pressure (MAP) were recorded and evaluated by Ricker sedation agitation score (SAS).At the same time,the EEG power value changes of four frequency bands (α,β,θ,and δ) were recorded constantly.Correlation analysis was performed between the changing power values and corresponding SAS.Results (1) During sedation,the body temperature,respiration,heart rate,SpO2 and MAP did not show significant fluctuation along with the decrease of SAS (P ＞ 0.01).(2) Before and after Dex sedation,the electroencephalography power value of the delta band was negatively correlated with SAS,with the correlation coefficient absolute value between 0.85 and 0.88 (P ＜ 0.01).The highest absolute value of the correlation coefficient was that of the left frontal and of the right frontal region (0.88,P ＜0.01).The absolute value of the correlation coefficient between (θ + δ)/(α + β) and SAS was between 0.75 and 0.85 (P ＜ 0.01).(3) The fast wave power (α and β band) in each brain area before sedation increased to varied degrees after the sedation,but it decreased along with the falling SAS.The absolute value of correlation coefficient between the electroencephalography power value in α and β band ranged from 0.29 to 0.48 (P ＜ 0.01),indicating weak correlation.There was no significant correlation between the EEG values in the θ band and SAS (P ＞ 0.01).Conclusions The electroencephalography power values of the δ band of each brain region are negatively correlated with SAS and can objectively reflect the dynamic changes of the sedation depth.The absolute values of correlation coefficient between bilateral frontal δ band power and SAS can serve as a better guide for clinical sedation.