A retrospective study of electroencephalography burst suppression in children undergoing general anesthesia.

Abstract

ABSTRACTImportanceIn children, anesthesia dosages are based on population pharmacokinetics and patient hemodynamics rather than patient‐specific brain activity. Brain function is highly susceptible to the effects of anesthetics.ObjectiveThe primary objective of this retrospective pilot study was to assess the prevalence of electroencephalography (EEG) burst suppression—a sign of deep anesthesia—in children undergoing general anesthesia.MethodsWe analyzed EEG in patients aged 1–36 months who received sevoflurane or propofol as the primary anesthetic. Patient enrollment was stratified into two age groups: 1–12 months and 13–36 months. Burst suppression (voltage ≤ 5.0 mV, lasting > 0.5 seconds) was characterized by occurrence over anesthesia time. Associations with patient demographics and anesthetics were determined.ResultsIn total, 54 patients (33 males and 21 females) were included in the study [age 11.0 (5.0–19.5) months; weight 9.2 (6.5–11.0) kg]. The total prevalence of burst suppression was 56% (30/54). Thirty‐three percent of patients experienced burst suppression during the surgical phase. The greatest proportion of burst suppression occurred during the induction phase. More burst suppression event occurrences (18/30) were observed in the patient under sevoflurane anesthesia (P = 0.024). Virtually all patients who received propofol boluses had burst suppression (P = 0.033). More burst suppression occurred in patients with hypotension (P < 0.001). During the surgical phase, a younger age was associated with more burst suppression (P = 0.002).InterpretationEEG burst suppression was associated with younger age, inhalation anesthetics, propofol bolus, and lower arterial pressure.