Abstract
Background: Sleep characteristics have been used for prediction of neurodevelopmental outcome and may also be useful to determine quality of recovery after surgery. Cerebral monitoring has not previously been routinely used to observe effects of anaesthesia and surgery on the developing brain.
The aim of this prospective study was to evaluate the influence of anesthesia on the recovery of SWC in term newborns after surgery.
Methods: Term neonates admitted to NICU who underwent major intra-abdominal surgery were studied. The Brainz® monitor was applied postoperatively using the standard C3, C4 and P3, P4 positions. Subjects were monitored until mature SWC were observed and the time of onset and quality of SWC together with the background pattern were then assessed.
Results: Fourty-seven patients were recruited. Surgery was performed for congenital diaphragmatic hernia (15), esophageal atresia (12), duodenal and jejunal atresia (7), ileal obstruction (3), exomphalos (3), gastroschisis (4), malrotation (1), meconium ileus (1) and a patent urachus (1). When patients returned to the NICU morphine and midazolam infusions were commenced. Emergence of SWC was observed at a median of 13 hours after surgery (range 1 to 136 hours). SWC became mature at a median of 30 hours (range 4 to 175 hours). All patients were still on morphine and midazolam infusions at this stage.
Conclusion: The emergence of sleep-wake cycling on aEEG after surgery can be observed as early as one hour post-operatively and appears not to be affected by high dose infusions of morphine and midazolam.
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Olischar, M., Davidson, A. & Hunt, R. 576 Recovery of Sleep-Wake Cycling on Amplitude-Integrated Electroencephalography in Postsurgical Term Neonates. Pediatr Res 68 (Suppl 1), 295 (2010). https://doi.org/10.1203/00006450-201011001-00576
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DOI: https://doi.org/10.1203/00006450-201011001-00576