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Jiang J, Zhao Y, Liu J, Yang Y, Liang P, Huang H, Wu Y, Kang Y, Zhu T, Zhou C. Signatures of Thalamocortical Alpha Oscillations and Synchronization With Increased Anesthetic Depths Under Isoflurane. Front Pharmacol 2022; 13:887981. [PMID: 35721144 PMCID: PMC9204038 DOI: 10.3389/fphar.2022.887981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Electroencephalography (EEG) recordings under propofol exhibit an increase in slow and alpha oscillation power and dose-dependent phase–amplitude coupling (PAC), which underlie GABAA potentiation and the central role of thalamocortical entrainment. However, the exact EEG signatures elicited by volatile anesthetics and the possible neurophysiological mechanisms remain unclear.Methods: Cortical EEG signals and thalamic local field potential (LFP) were recorded in a mouse model to detect EEG signatures induced by 0.9%, 1.5%, and 2.0% isoflurane. Then, the power of the EEG spectrum, thalamocortical coherence, and slow–alpha phase–amplitude coupling were analyzed. A computational model based on the thalamic network was used to determine the primary neurophysiological mechanisms of alpha spiking of thalamocortical neurons under isoflurane anesthesia.Results: Isoflurane at 0.9% (light anesthesia) increased the power of slow and delta oscillations both in cortical EEG and in thalamic LFP. Isoflurane at 1.5% (surgery anesthesia) increased the power of alpha oscillations both in cortical EEG and in thalamic LFP. Isoflurane at 2% (deep anesthesia) further increased the power of cortical alpha oscillations, while thalamic alpha oscillations were unchanged. Thalamocortical coherence of alpha oscillation only exhibited a significant increase under 1.5% isoflurane. Isoflurane-induced PAC modulation remained unchanged throughout under various concentrations of isoflurane. By adjusting the parameters in the computational model, isoflurane-induced alpha spiking in thalamocortical neurons was simulated, which revealed the potential molecular targets and the thalamic network involved in isoflurane-induced alpha spiking in thalamocortical neurons.Conclusion: The EEG changes in the cortical alpha oscillation, thalamocortical coherence, and slow–alpha PAC may provide neurophysiological signatures for monitoring isoflurane anesthesia at various depths.
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Affiliation(s)
- Jingyao Jiang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yi Zhao
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Jin Liu
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Yaoxin Yang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Peng Liang
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Han Huang
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Chengdu, China
| | - Yongkang Wu
- Intelligent Manufacturing Institute, Chengdu Jincheng College, Chengdu, China
| | - Yi Kang
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
| | - Tao Zhu
- Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Tao Zhu, ; Cheng Zhou,
| | - Cheng Zhou
- Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Tao Zhu, ; Cheng Zhou,
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Yonezawa H, Maeda T, Takise Y, Morinaga M, Ohnishi Y. Abnormally high Patient State Index associated with epicardial pacing: a case report. JA Clin Rep 2022; 8:35. [PMID: 35596095 PMCID: PMC9123133 DOI: 10.1186/s40981-022-00521-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/03/2022] [Accepted: 04/10/2022] [Indexed: 11/28/2022] Open
Abstract
Background Anesthesiologists monitor electroencephalography (EEG) intraoperatively to maintain adequate depth of anesthesia. However, the EEG signal is affected by noise and interference. The SedLine® is a brain function monitor with which the Patient State Index (PSI) is calculated. In this study, we report abnormally high PSI values associated with epicardial pacing during open heart surgery. Case presentation A 50-year-old man was scheduled for total arch replacement. Atrial demand pacing was started before weaning from cardiopulmonary bypass. The PSI increased from 30 to 80 soon after the start of pacing, and the EEG waveform showed spikes synchronized with the pacing. As the pacing output was lowered, the spikes on the EEG attenuated and disappeared, and the PSI decreased to < 40. When the pacing output was increased again, the spikes recurred, and the PSI increased again. Conclusions Pacemaker spikes may cause contamination of the EEG, resulting in abnormally high PSI values.
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Affiliation(s)
- Hiroki Yonezawa
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita City, Osaka, 564-8565, Japan.
| | - Takuma Maeda
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita City, Osaka, 564-8565, Japan
| | - Yoshiaki Takise
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita City, Osaka, 564-8565, Japan
| | - Masahiro Morinaga
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita City, Osaka, 564-8565, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita City, Osaka, 564-8565, Japan
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Cavaliere F, Allegri M, Apan A, Brazzi L, Carassiti M, Cohen E, DI Marco P, Langeron O, Rossi M, Spieth P, Turnbull D, Weber F. A year in review in Minerva Anestesiologica 2021. Anesthesia, analgesia, and perioperative medicine. Minerva Anestesiol 2022; 88:206-216. [PMID: 35315631 DOI: 10.23736/s0375-9393.22.16429-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Franco Cavaliere
- IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy -
| | - Massimo Allegri
- Unit of Pain Therapy of Column and Athlete, Policlinic of Monza, Monza-Brianza, Italy.,Italian Pain Group, Milan, Italy
| | - Alparslan Apan
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Giresun, Giresun, Turkey
| | - Luca Brazzi
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Massimiliano Carassiti
- Unit of Anesthesia, Intensive Care and Pain Management, Campus Bio-Medico University Hospital, Rome, Italy
| | - Edmond Cohen
- Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pierangelo DI Marco
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic, and Geriatric Sciences, Faculty of Medicine, Sapienza University, Rome, Italy
| | - Olivier Langeron
- Department of Anesthesia and Intensive Care, Henri Mondor University Hospital, Assistance Publique - Hôpitaux de Paris (APHP), University Paris-Est Créteil (UPEC), Paris, France
| | - Marco Rossi
- IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Peter Spieth
- Department of Anesthesiology and Critical Care Medicine, University Hospital of Dresden, Dresden, Germany
| | - David Turnbull
- Department of Anesthetics and Neuro Critical Care, Royal Hallamshire Hospital, Sheffield, UK
| | - Frank Weber
- Department of Anesthesiology, Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands
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