Effects of Two Different Sedation Regimes on Auditory Evoked Potentials and Electroencephalogram (EEG)
Status:
Completed
Trial end date:
2004-06-01
Target enrollment:
Participant gender:
Summary
Sedation may be necessary in intensive care to facilitate diverse therapeutic interventions,
but the use of sedative drugs may increase the risk of delirium and long-term cognitive
impairment. Thus the implementation and monitoring of sedation remains difficult despite the
use of sedation protocols and clinical sedation scores. Attempts to improve sedation
monitoring through the use of the electroencephalogram(EEG) have been disappointing. Derived
variables based on the unstimulated EEG fail to predict the response to external stimuli at
the clinically most relevant light-to-moderate sedation levels, and the overlap between
moderate and deep sedation levels is wide. We have demonstrated that long-latency auditory
evoked potentials (ERPs)can be used to avoid deep levels of sedation in healthy volunteers
during propofol sedation, independent of the concomitant administration of remifentanil. This
approach has a potential clinical application for improved monitoring of sedation. Since the
effects of different sedative drugs on the EEG may vary widely, the use of ERPs to monitor
sedation needs to be evaluated with different sedative drugs. Therefore we will administer
two widely used drug combinations (dexmedetomidine/remifentanil and midazolam/remifentanil)
in healthy volunteers and record ERPS and processed EEG during clinical relevant sedation
levels