Clinical electroencephalography for anesthesiologists

Anesthesiology

Volumn 123, Issue 4, 2015, Pages 937-960

  Purdon, Patrick L ^a   Sampson, Aaron ^b   Pavone, Kara J ^c   Brown, Emery N ^c  

^a MASSACHUSETTS GENERAL HOSPITAL   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c MASSACHUSETTS INSTITUTE OF TECHNOLOGY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

4 AMINOBUTYRIC ACID A RECEPTOR; ANESTHETIC AGENT; DESFLURANE; DEXMEDETOMIDINE; ISOFLURANE; KETAMINE; NITROUS OXIDE; PROPOFOL; SEVOFLURANE;

ALPHA RHYTHM; ANESTHESIST; BETA RHYTHM; DELTA RHYTHM; ELECTROENCEPHALOGRAM; ELECTROENCEPHALOGRAPHY; GAMMA RHYTHM; GENERAL ANESTHESIA; HUMAN; OSCILLATION; PATIENT CARE; POSTSYNAPTIC POTENTIAL; PRIORITY JOURNAL; REVIEW; SEDATION; THETA RHYTHM; UNCONSCIOUSNESS; ANESTHESIA; BRAIN; CHEMICALLY INDUCED; DRUG EFFECTS; PATHOPHYSIOLOGY; PROCEDURES;

ANESTHESIA; ANESTHETICS; BRAIN; ELECTROENCEPHALOGRAPHY; HUMANS; UNCONSCIOUSNESS;

EID: 84942028783     PISSN: 00033022     EISSN: 15281175     Source Type: Journal    
DOI: 10.1097/ALN.0000000000000841     Document Type: Review

References (133)

1. Gibbs FA, Gibbs LE, Lennox WG: Effects on the electroencephalogram of certain drugs which influence nervous activity. Arch Intern Med 1937; 60:154-66
2. Faulconer A, Bickford RG: Electroencephalography in anesthesiology, American Lecture Series. Springfield, Thomas, 1960, pp 28-50
3. Faulconer A, Pender JW, Bickford RG: The influence of partial pressure of nitrous oxide on the depth of anesthesia and the electro-encephalogram in man. Anesthesiolog y 1949; 10:601-9
4. Kiersey DK, Bickford RG, Faulconer A Jr: Electroencephalographic patterns produced by thiopental sodium during surgical operations; description and classification. Br J Anaesth 1951; 23:141-52
5. Galla SJ, Rocco AG, Vandam LD: Evaluation of the traditional signs and stages of anesthesia: An electroencephalographic and clinical study. Anesthesiolog y 1958; 19:328-38
6. Martin JT, Faulconer A Jr, Bickford RG: Electroencephalography in anesthesiology. Anesthesiolog y 1959; 20:359-76
7. Faulconer A Jr: Correlation of concentrations of ether in arterial blood with electro-encephalographic patterns occurring during ether-oxygen and during nitrous oxide, oxygen and ether anesthesia of human surgical patients. Anesthesiolog y 1952; 13:361-9
8. Bart AJ, Homi J, Linde HW: Changes in power spectra of electroencephalograms during anesthesia with fluroxene, methoxyflurane and ethrane. Anesth Analg 1971; 50:53-63
9. Findeiss JC, Kien GA, Huse KO, Linde HW: Power spectral density of the electroencephalogram during halothane and cyclopropane anesthesia in man. Anesth Analg 1969; 48:1018-23
10. Bickford RG, Fleming N, Billinger T: Compression of EEG data. Trans Am Neurol Assoc 1971; 96:118-22
11. Myers RR, Stockard JJ, Fleming NI, France CJ, Bickford RG: The use of on-line telephonic computer analysis of the E.E.G. in anaesthesia. Br J Anaesth 1973; 45:664-70
12. Fleming RA, Smith NT: An inexpensive device for analyzing and monitoring the electroencephalogram. Anesthesiolog y 1979; 50:456-60
13. Levy WJ, Shapiro HM, Maruchak G, Meathe E: Automated EEG processing for intraoperative monitoring: A comparison of techniques. Anesthesiolog y 1980; 53:223-36
14. Levy WJ: Intraoperative EEG patterns: Implications for EEG monitoring. Anesthesiolog y 1984; 60:430-4
15. Tinker JH, Sharbrough FW, Michenfelder JD: Anterior shift of the dominant EEG rhythm during anesthesia in the Java monkey: Correlation with anesthetic potency. Anesthesiolog y 1977; 46:252-9
16. John ER, Prichep LS, Kox W, Valdés-Sosa P, Bosch-Bayard J, Aubert E, Tom M, di Michele F, Gugino LD, diMichele F: Invariant reversible QEEG effects of anesthetics. Conscious Cogn 2001; 10:165-83
17. Gugino LD, Chabot RJ, Prichep LS, John ER, Formanek V, Aglio LS: Quantitative EEG changes associated with loss and return of consciousness in healthy adult volunteers anaesthetized with propofol or sevoflurane. Br J Anaesth 2001; 87:421-8
18. Feshchenko VA, Veselis RA, Reinsel RA: Propofol-induced alpha rhythm. Neuropsychobiology 2004; 50:257-66
19. Cimenser A, Purdon PL, Pierce ET, Walsh JL, Salazar-Gomez AF, Harrell PG, Tavares-Stoeckel C, Habeeb K, Brown EN: Tracking brain states under general anesthesia by using global coherence analysis. Proc Natl Acad Sci U S A 2011; 108:8832-7
20. Purdon PL, Pierce ET, Mukamel EA, Prerau MJ, Walsh JL, Wong KF, Salazar-Gomez AF, Harrell PG, Sampson AL, Cimenser A, Ching S, Kopell NJ, Tavares-Stoeckel C, Habeeb K, Merhar R, Brown EN: Electroencephalogram signatures of loss and recovery of consciousness from propofol. Proc Natl Acad Sci U S A 2013; 110:E1142-51
21. Schneider G, Gelb AW, Schmeller B, Tschakert R, Kochs E: Detection of awareness in surgical patients with EEG-based indices-Bispectral index and patient state index. Br J Anaesth 2003; 91:329-35
22. Rampil IJ: A primer for EEG signal processing in anesthesia. Anesthesiolog y 1998; 89:980-1002
23. Palanca BJ, Mashour GA, Avidan MS: Processed electroencephalogram in depth of anesthesia monitoring. Curr Opin Anaesthesiol 2009; 22:553-9
24. Bol CJJG, Danhof M, Stanski DR, Mandema JW: Pharmacokineticpharmacodynamic characterization of the cardiovascular, hypnotic, EEG and ventilatory responses to dexmedetomidine in the rat. J Pharmacol Exp Ther 1997; 283:1051-8
25. Barnard JP, Bennett C, Voss LJ, Sleigh JW: Can anaesthetists be taught to interpret the effects of general anaesthesia on the electroencephalogram? Comparison of performance with the BIS and spectral entropy. Br J Anaesth 2007; 99:532-7
26. Kearse LA Jr, Manberg P, Chamoun N, deBros F, Zaslavsky A: Bispectral analysis of the electroencephalogram correlates with patient movement to skin incision during propofol/nitrous oxide anesthesia. Anesthesiolog y 1994; 81:1365-70
27. Glass PS, Bloom M, Kearse L, Rosow C, Sebel P, Manberg P: Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, and alfentanil in healthy volunteers. Anesthesiolog y 1997; 86:836-47
28. Prichep LS, Gugino LD, John ER, Chabot RJ, Howard B, Merkin H, Tom ML, Wolter S, Rausch L, Kox WJ: The Patient State Index as an indicator of the level of hypnosis under general anaesthesia. Br J Anaesth 2004; 92:393-9
29. Drover D, Ortega HR: Patient state index. Best Pract Res Clin Anaesthesiol 2006; 20:121-8
30. Schultz B, Kreuer S, Wilhelm W, Grouven U, Schultz A: [The Narcotrend monitor. Development and interpretation algorithms]. Anaesthesist 2003; 52:1143-8
31. Kreuer S, Wilhelm W: The Narcotrend monitor. Best Pract Res Clin Anaesthesiol 2006; 20:111-9
32. Viertiö-Oja H, Maja V, Särkelä M, Talja P, Tenkanen N, Tolvanen-Laakso H, Paloheimo M, Vakkuri A, Yli-Hankala A, Meriläinen P: Description of the Entropy algorithm as applied in the Datex-Ohmeda S/5 Entropy Module. Acta Anaesthesiol Scand 2004; 48:154-61
33. Jäntti V, Alahuhta S: Spectral entropy-What has it to do with anaesthesia, and the EEG? Br J Anaesth 2004; 93:150-1; author reply 151-2
34. Avidan MS, Zhang L, Burnside BA, Finkel KJ, Searleman AC, Selvidge JA, Saager L, Turner MS, Rao S, Bottros M, Hantler C, Jacobsohn E, Evers AS: Anesthesia awareness and the bispectral index. N Engl J Med 2008; 358:1097-108
35. Avidan MS, Jacobsohn E, Glick D, Burnside BA, Zhang L, Villafranca A, Karl L, Kamal S, Torres B, O'Connor M, Evers AS, Gradwohl S, Lin N, Palanca BJ, Mashour GA, Group B-RR: Prevention of intraoperative awareness in a high-risk surgical population. N Engl J Med 2011; 365:591-600
36. Samarkandi AH: The bispectral index system in pediatrics-Is it related to the end-Tidal concentration of inhalation anesthetics? Middle East J Anaesthesiol 2006; 18:769-78
37. Tirel O, Wodey E, Harris R, Bansard JY, Ecoffey C, Senhadji L: Variation of bispectral index under TIVA with propofol in a paediatric population. Br J Anaesth 2008; 100:82-7
38. H ayashi K, Tsuda N, Sawa T, Hagihira S: Ketamine increases the frequency of electroencephalographic bicoherence peak on the alpha spindle area induced with propofol. Br J Anaesth 2007; 99:389-95
39. Tsuda N, Hayashi K, Hagihira S, Sawa T: Ketamine, an NMDAantagonist, increases the oscillatory frequencies of alphapeaks on the electroencephalographic power spectrum. Acta Anaesthesiol Scand 2007; 51:472-81
40. Y amamura T, Fukuda M, Takeya H, Goto Y, Furukawa K: Fast oscillatory EEG activity induced by analgesic concentrations of nitrous oxide in man. Anesth Analg 1981; 60:283-8
41. Foster BL, Liley DT: Nitrous oxide paradoxically modulates slow electroencephalogram oscillations: Implications for anesthesia monitoring. Anesth Analg 2011; 113:758-65
42. Foster BL, Liley DT: Effects of nitrous oxide sedation on resting electroencephalogram topography. Clin Neurophysiol 2013; 124:417-23
43. Akeju O, Pavone KJ, Westover MB, Vazquez R, Prerau MJ, Harrell PG, Hartnack KE, Rhee J, Sampson AL, Habeeb K, Gao L, Lei G, Pierce ET, Walsh JL, Brown EN, Purdon PL: A comparison of propofol-And dexmedetomidine-induced electroencephalogram dynamics using spectral and coherence analysis. Anesthesiolog y 2014; 121:978-89
44. H uupponen E, Maksimow A, Lapinlampi P, Särkelä M, Saastamoinen A, Snapir A, Scheinin H, Scheinin M, Meriläinen P, Himanen SL, Jääskeläinen S: Electroencephalogram spindle activity during dexmedetomidine sedation and physiological sleep. Acta Anaesthesiol Scand 2008; 52:289-94
45. Brown EN, Purdon PL, Van Dort CJ: General anesthesia and altered states of arousal: A systems neuroscience analysis. Annu Rev Neurosci 2011; 34:601-28
46. Brown EN, Lydic R, Schiff ND: General anesthesia, sleep, and coma. N Engl J Med 2010; 363:2638-50
47. Akeju O, Westover MB, Pavone KJ, Sampson AL, Hartnack KE, Brown EN, Purdon PL: Effects of sevoflurane and propofol on frontal electroencephalogram power and coherence. Anesthesiolog y 2014; 121:990-8
48. Kertai MD, Whitlock EL, Avidan MS: Brain monitoring with electroencephalography and the electroencephalogramderived bispectral index during cardiac surgery. Anesth Analg 2012; 114:533-46
49. Bennett C, Voss LJ, Barnard JP, Sleigh JW: Practical use of the raw electroencephalogram waveform during general anesthesia: The art and science. Anesth Analg 2009; 109:539-50
50. Drover DR, Schmiesing C, Buchin AF, Ortega HR, Tanner JW, Atkins JH, Macario A: Titration of sevoflurane in elderly patients: Blinded, randomized clinical trial, in non-cardiac surgery after beta-Adrenergic blockade. J Clin Monit Comput 2011; 25:175-81
51. Kandel ER, Schwartz JH, Jessell TM, Siegelbaum SA, Hudspeth AJ: Nerve cells and behavior, Principles of Neural Science, 5th edition. New York, McGraw-Hill, 2013, pp 19-35
52. Buzsa?ki G: Synchronization by oscillation, Rhythms of the Brain. Oxford; New York, Oxford University Press, 2006, pp 136-174
53. Buzsáki G, Anastassiou CA, Koch C: The origin of extracellular fields and currents-EEG, ECoG, LFP and spikes. Nat Rev Neurosci 2012; 13:407-20
54. H ughes SW, Crunelli V: Thalamic mechanisms of EEG alpha rhythms and their pathological implications. Neuroscientist 2005; 11:357-72
55. Purves D, Augustine GJ, Fitzpatrick D, Hall WC, LaMantis AS, McNamara JO, White LE: Neuroscience, 4th edition. Sunderland, Sinauer Associates, Inc., 2008, pp 715-17
56. H amalainen M, Hari R, Ilmoniemi RJ, Knuutila J, Lounasmaa OV: Magnetoencephalography-Theory, instrumentation, and applications to noninvasive studies of the working human brain. Reviews of Modern Physics 1993; 65:413-497
57. Ching S, Cimenser A, Purdon PL, Brown EN, Kopell NJ: Thalamocortical model for a propofol-induced alpha-rhythm associated with loss of consciousness. Proc Natl Acad Sci U S A 2010; 107:22665-70
58. Supp GG, Siegel M, Hipp JF, Engel AK: Cortical hypersynchrony predicts breakdown of sensory processing during loss of consciousness. Curr Biol 2011; 21:1988-93
59. Chauvette S, Crochet S, Volgushev M, Timofeev I: Properties of slow oscillation during slow-wave sleep and anesthesia in cats. J Neurosci 2011; 31:14998-5008
60. Lewis LD, Weiner VS, Mukamel EA, Donoghue JA, Eskandar EN, Madsen JR, Anderson WS, Hochberg LR, Cash SS, Brown EN, Purdon PL: Rapid fragmentation of neuronal networks at the onset of propofol-induced unconsciousness. Proc Natl Acad Sci U S A 2012; 109:E3377-86
61. Li D, Voss LJ, Sleigh JW, Li X: Effects of volatile anesthetic agents on cerebral cortical synchronization in sheep. Anesthesiolog y 2013; 119:81-8
62. Wang K, Steyn-Ross ML, Steyn-Ross DA, Wilson MT, Sleigh JW: EEG slow-wave coherence changes in propofol-induced general anesthesia: Experiment and theory. Front Syst Neurosci 2014; 8:215
63. Vizuete JA, Pillay S, Ropella KM, Hudetz AG: Graded defragmentation of cortical neuronal firing during recovery of consciousness in rats. Neuroscience 2014; 275:340-51
64. Mitra PP, Bokil H: Nonparametric Quadratic Estimates, Observed Brain Dynamics. Edited by Mirta PP, Bokil H. New York, Oxford University Press, 2008, pp 194-196
65. Babadi B, Brown EN: A review of multitaper spectral analysis. IEEE Trans Biomed Eng 2014; 61:1555-64
66. McCarley RW: Neurobiology of REM and NREM sleep. Sleep Med 2007; 8:302-30
67. Niedermeyer E: Abnormal EEG patterns: Epileptic and paroxysmal, Electroencephalography: Basic Principles, Clinical Applications, and Related Fields, 5th edition. Edited by Niedermeyer E, da Silva FL. Philadelphia, Lippincott Williams & Wilkins, 2005, pp 255-80
68. Besch G, Liu N, Samain E, Pericard C, Boichut N, Mercier M, Chazot T, Pili-Floury S: Occurrence of and risk factors for electroencephalogram burst suppression during propofolremifentanil anaesthesia. Br J Anaesth 2011; 107:749-56
69. Purdon PL, Brown EN: Clinical Electroencephalography for Anesthesiologists, Partners Healthcare Office of Continuing Professional Development, 2014. Available at: www. AnesthesiaEEG.com
70. Schwilden H, Schöttler J, Stoeckel H: Closed-loop feedback control of methohexital anesthesia by quantitative EEG analysis in humans. Anesthesiolog y 1987; 67:341-7
71. Drummond JC, Brann CA, Perkins DE, Wolfe DE: A comparison of median frequency, spectral edge frequency, a frequency band power ratio, total power, and dominance shift in the determination of depth of anesthesia. Acta Anaesthesiol Scand 1991; 35:693-9
72. H emmings HC Jr, Akabas MH, Goldstein PA, Trudell JR, Orser BA, Harrison NL: Emerging molecular mechanisms of general anesthetic action. Trends Pharmacol Sci 2005; 26:503-10
73. Bai D, Pennefather PS, MacDonald JF, Orser BA: The general anesthetic propofol slows deactivation and desensitization of GABA(A) receptors. J Neurosci 1999; 19:10635-46
74. Brown EN, Solt K, Purdon PL, Akeju O: Monitoring brain states during general anesthesia and sedation, Miller's Anesthesia, 8th edition. Edited by Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL, eds. Philadelphia, Elsevier; 2014, pp 1524-1540
75. Devor M, Zalkind V: Reversible analgesia, atonia, and loss of consciousness on bilateral intracerebral microinjection of pentobarbital. Pain 2001; 94:101-12
76. Williams ST, Conte MM, Goldfine AM, Noirhomme Q, Gosseries O, Thonnard M, Beattie B, Hersh J, Katz DI, Victor JD, Laureys S, Schiff ND: Common resting brain dynamics indicate a possible mechanism underlying zolpidem response in severe brain injury. Elife 2013; 2:e01157
77. McCarthy MM, Brown EN, Kopell N: Potential network mechanisms mediating electroencephalographic beta rhythm changes during propofol-induced paradoxical excitation. J Neurosci 2008; 28:13488-504
78. Feldman JL, Del Negro CA: Looking for inspiration: New perspectives on respiratory rhythm. Nat Rev Neurosci 2006; 7:232-42
79. Redlich FC, Callahan A, Mendelson RH: Electroencephalographic changes after eye opening and visual stimulation. Yale J Biol Med 1946; 18:367-76
80. Lee U, Ku S, Noh G, Baek S, Choi B, Mashour GA: Disruption of frontal-parietal communication by ketamine, propofol, and sevoflurane. Anesthesiolog y 2013; 118:1264-75
81. Imas OA, Ropella KM, Ward BD, Wood JD, Hudetz AG: Volatile anesthetics disrupt frontal-posterior recurrent information transfer at gamma frequencies in rat. Neurosci Lett 2005; 387:145-50
82. Jordan D, Ilg R, Riedl V, Schorer A, Grimberg S, Neufang S, Omerovic A, Berger S, Untergehrer G, Preibisch C, Schulz E, Schuster T, Schröter M, Spoormaker V, Zimmer C, Hemmer B, Wohlschläger A, Kochs EF, Schneider G: Simultaneous electroencephalographic and functional magnetic resonance imaging indicate impaired cortical top-down processing in association with anesthetic-induced unconsciousness. Anesthesiolog y 2013; 119:1031-42
83. Rampil IJ, Lockhart SH, Eger EI II, Yasuda N, Weiskopf RB, Cahalan MK: The electroencephalographic effects of desflurane in humans. Anesthesiolog y 1991; 74:434-9
84. Amzica F: Basic physiology of burst-suppression. Epilepsia 2009; 50(suppl 12):38-9
85. Ching S, Purdon PL, Vijayan S, Kopell NJ, Brown EN: A neurophysiological-metabolic model for burst suppression. Proc Natl Acad Sci U S A 2012; 109:3095-100
86. Mirsattari SM, Sharpe MD, Young GB: Treatment of refractory status epilepticus with inhalational anesthetic agents isoflurane and desflurane. Arch Neurol 2004; 61:1254-9
87. Stecker MM, Cheung AT, Pochettino A, Kent GP, Patterson T, Weiss SJ, Bavaria JE: Deep hypothermic circulatory arrest: I. Effects of cooling on electroencephalogram and evoked potentials. Ann Thorac Surg 2001; 71:14-21
88. Doyle PW, Matta BF: Burst suppression or isoelectric encephalogram for cerebral protection: Evidence from metabolic suppression studies. Br J Anaesth 1999; 83:580-4
89. Rossetti AO, Reichhart MD, Schaller MD, Despland PA, Bogousslavsky J: Propofol treatment of refractory status epilepticus: A study of 31 episodes. Epilepsia 2004; 45:757-63
90. H unter G, Young GB: Status epilepticus: A review, with emphasis on refractory cases. Can J Neurol Sci 2012; 39:157-69
91. Lewis LD, Ching S, Weiner VS, Peterfreund RA, Eskandar EN, Cash SS, Brown EN, Purdon PL: Local cortical dynamics of burst suppression in the anaesthetized brain. Brain 2013; 136(Pt 9):2727-37
92. Kroeger D, Amzica F: Hypersensitivity of the anesthesiainduced comatose brain. J Neurosci 2007; 27:10597-607
93. Koenig MA, Kaplan PW, Thakor NV: Clinical neurophysiologic monitoring and brain injury from cardiac arrest. Neurol Clin 2006; 24:89-106
94. Y amatogi Y, Ohtahara S: Early-infantile epileptic encephalopathy with suppression-bursts, Ohtahara syndrome; its overview referring to our 16 cases. Brain Dev 2002; 24:13-23
95. Rampil I: Consciousness, awareness, and the clinician. Can J Anesth 2003; 50:R1-5
96. Rampil IJ, Weiskopf RB, Brown JG, Eger EI II, Johnson BH, Holmes MA, Donegan JH: I653 and isoflurane produce similar dose-related changes in the electroencephalogram of pigs. Anesthesiolog y 1988; 69:298-302
97. Bruhn J, Bouillon TW, Shafer SL: Bispectral index (BIS) and burst suppression: Revealing a part of the BIS algorithm. J Clin Monit Comput 2000; 16:593-6
98. Voss L, Sleigh J: Monitoring consciousness: The current status of EEG-based depth of anaesthesia monitors. Best Pract Res Clin Anaesthesiol 2007; 21:313-25
99. Chemali J, Ching S, Purdon PL, Solt K, Brown EN: Burst suppression probability algorithms: State-space methods for tracking EEG burst suppression. J Neural Eng 2013; 10:1741-2560
100. Shanechi MM, Chemali JJ, Liberman M, Solt K, Brown EN: A brain-machine interface for control of medically-induced coma. PLoS Comput Biol 2013; 9: e1003284
101. Sinner B, Graf BM: Ketamine. Handb Exp Pharmacol 2008; 182:313-33
102. Olney JW, Farber NB: Glutamate receptor dysfunction and schizophrenia. Arch Gen Psychiatry 1995; 52:998-1007
103. Seamans J: Losing inhibition with ketamine. Nat Chem Biol 2008; 4:91-3
104. Moghaddam B, Adams B, Verma A, Daly D: Activation of glutamatergic neurotransmission by ketamine: A novel step in the pathway from NMDA receptor blockade to dopaminergic and cognitive disruptions associated with the prefrontal cortex. J Neurosci 1997; 17:2921-7
105. Cavazzuti M, Porro CA, Biral GP, Benassi C, Barbieri GC: Ketamine effects on local cerebral blood flow and metabolism in the rat. J Cereb Blood Flow Metab 1987; 7:806-11
106. Strebel S, Kaufmann M, Maitre L, Schaefer HG: Effects of ketamine on cerebral blood flow velocity in humans. Influence of pretreatment with midazolam or esmolol. Anaesthesia 1995; 50:223-8
107. Vollenweider FX, Leenders KL, Oye I, Hell D, Angst J: Differential psychopathology and patterns of cerebral glucose utilisation produced by (S)-And-ketamine in healthy volunteers using positron emission tomography (PET). Eur Neuropsychopharmacol 1997; 7:25-38
108. Jorm CM, Stamford JA: Actions of the hypnotic anaesthetic, dexmedetomidine, on noradrenaline release and cell firing in rat locus coeruleus slices. Br J Anaesth 1993; 71:447-9
109. Nacif-Coelho C, Correa-Sales C, Chang LL, Maze M: Perturbation of ion channel conductance alters the hypnotic response to the α2-Adrenergic agonist dexmedetomidine in the locus coeruleus of the rat. Anesthesiolog y 1994; 81:1527-34
110. Nelson LE, Lu J, Guo T, Saper CB, Franks NP, Maze M: The α2-Adrenoceptor agonist dexmedetomidine converges on an endogenous sleep-promoting pathway to exert its sedative effects. Anesthesiolog y 2003; 98:428-36
111. Nelson LE, Guo TZ, Lu J, Saper CB, Franks NP, Maze M: The sedative component of anesthesia is mediated by GABA(A) receptors in an endogenous sleep pathway. Nat Neurosci 2002; 5:979-84
112. Saper CB, Scammell TE, Lu J: Hypothalamic regulation of sleep and circadian rhythms. Nature 2005; 437:1257-63
113. Sherin JE, Elmquist JK, Torrealba F, Saper CB: Innervation of histaminergic tuberomammillary neurons by GABAergic and galaninergic neurons in the ventrolateral preoptic nucleus of the rat. J Neurosci 1998; 18:4705-21
114. Morairty S, Rainnie D, McCarley R, Greene R: Disinhibition of ventrolateral preoptic area sleep-Active neurons by adenosine: A new mechanism for sleep promotion. Neuroscience 2004; 123:451-7
115. España RA, Berridge CW: Organization of noradrenergic efferents to arousal-related basal forebrain structures. J Comp Neurol 2006; 496:668-83
116. Akeju O, Loggia ML, Catana C, Pavone KJ, Vazquez R, Rhee J, Contreras Ramirez V, Chonde DB, Izquierdo-Garcia D, Arabasz G, Hsu S, Habeeb K, Hooker JM, Napadow V, Brown EN, Purdon PL: Disruption of thalamic functional connectivity is a neural correlate of dexmedetomidineinduced unconsciousness. Elife 2014; 4:e04499
117. Destexhe A, Contreras D, Steriade M: Mechanisms underlying the synchronizing action of corticothalamic feedback through inhibition of thalamic relay cells. J Neurophysiol 1998; 79:999-1016
118. Nir Y, Staba RJ, Andrillon T, Vyazovskiy VV, Cirelli C, Fried I, Tononi G: Regional slow waves and spindles in human sleep. Neuron 2011; 70:153-69
119. Antognini JF, Schwartz K: Exaggerated anesthetic requirements in the preferentially anesthetized brain. Anesthesiolog y 1993; 79:1244-9
120. Lyon R, Feiner J, Lieberman JA: Progressive suppression of motor evoked potentials during general anesthesia: The phenomenon of "anesthetic fade." J Neurosurg Anesthesiol 2005; 17:13-9
121. Andrews E: The oxygen mixture, a new anesthetic combination. Chic Med Exam 1868; 9:656-61
122. Avramov MN, Shingu K, Mori K: Progressive changes in electroencephalographic responses to nitrous oxide in humans: A possible acute drug tolerance. Anesth Analg 1990; 70:369-74
123. H agihira S, Takashina M, Mori T, Mashimo T: The impact of nitrous oxide on electroencephalographic bicoherence during isoflurane anesthesia. Anesth Analg 2012; 115:572-7
124. Pavone KJ, Akeju O, Sampson AL, Ling K, Purdon PL, Brown EN: Nitrous oxide-induced slow and delta oscillations. Clin Neurophysiol 2015; 10.1016/j.clinph.2015.06.001.
125. Jevtovi?-Todorovi? V, Todorovi? SM, Mennerick S, Powell S, Dikranian K, Benshoff N, Zorumski CF, Olney JW: Nitrous oxide (laughing gas) is an NMDA antagonist, neuroprotectant and neurotoxin. Nat Med 1998; 4:460-3
126. Moura LM, Shafi MM, Ng M, Pati S, Cash SS, Cole AJ, Hoch DB, Rosenthal ES, Westover MB: Spectrogram screening of adult EEGs is sensitive and efficient. Neurology 2014; 83:56-64
127. H ansen H, Classen J: EEG and evoked potentials in neuroanesthesia, intraoperative neurological monitoring, and neurointensive care, Electroencephalography: Basic Principles, Clinical Applications, and Related Fields, 5th edition. Edited by Niedermeyer E, da Silva FL. Philadelphia, Lippincott Williams & Wilkins, 2005, pp 1137-64
128. Blume WT, Sharbrough FW: EEG monitoring during carotid endarterectomy and open heart surgery, Electroencephalography: Basic Principles, Clinical Applications, and Related Fields, 5th edition. Edited by Niedermeyer E, da Silva FL. Philadelphia, Lippincott Williams & Wilkins, 2005, pp 815-28
129. Prerau MJ, Hartnack KE, Obregon-Henao G, Sampson A, Merlino M, Gannon K, Bianchi MT, Ellenbogen JM, Purdon PL: Tracking the sleep onset process: An empirical model of behavioral and physiological dynamics. PLoS Comput Biol 2014; 10:978-89
130. Sloan TB: Anesthetic effects on electrophysiologic recordings. J Clin Neurophysiol 1998; 15:217-26
131. Franks NP, Lieb WR: Do general anaesthetics act by competitive binding to specific receptors? Nature 1984; 310:599-601
132. Kelley SD: Monitoring Consciousness: Using the Bispectral Index, 2nd edition. Boulder, Covidien, 2010, pp 6
133. Bronez T: On the performance advantage of multitaper spectral analysis. IEEE Trans Signal Process 2002; 40:2941-46