title: Effects of midazolam and lidocaine on spectral properties of the EEG in full-term neonates with stroke.
abstract: Assessment of the neonatal EEG may be hampered by drug-specific changes in electrocortical activity. To quantify effects of a loading dose of midazolam and lidocaine on the EEG frequency spectrum of full-term neonates with perinatal arterial ischemic stroke (PAIS), 11 full-term infants underwent multi-channel amplitude-integrated EEG (aEEG) and EEG recordings. During recording, midazolam and/or lidocaine were administered as anti-epileptic drug. Retrospectively, we performed spectral analysis on 4-h EEG segments around the loading dose. The frequency spectrum was divided in δ (1-4 Hz), θ (4-8 Hz), α (8-13 Hz) and β (13-30 Hz) bands. Midazolam induced immediate suppression of the aEEG background pattern for 30-60 min. Spectral EEG analysis showed decreased total and absolute frequency band powers. Relative δ power decreased, θ power increased while α and β powers remained constant. Lidocaine induced no aEEG background pattern suppression. Total and absolute EEG band powers were unchanged. Relative δ power decreased, θ and α power increased and β power remained constant. Effects of lidocaine were more pronounced in the stroke-affected hemisphere. In conclusions, both drugs induced a shift from low to higher frequency electrocortical activity. Additionally, midazolam reduced total EEG power. These spectral changes differ from those seen in adult studies.
authors.affiliation: Dept. of Clinical Physics, Máxima Medical Centre, Veldhoven, The Netherlands.
authors.forename: Ward
authors.initials: W
authors.lastname: Jennekens
authors.forename: Frank
authors.initials: F
authors.lastname: Dankers
authors.forename: Fiere
authors.initials: F
authors.lastname: Janssen
authors.forename: Mona
authors.initials: M
authors.lastname: Toet
authors.forename: Niek
authors.initials: N
authors.lastname: van der Aa
authors.forename: Hendrik
authors.initials: H
authors.lastname: Niemarkt
authors.forename: Carola
authors.initials: C
authors.lastname: van Pul
authors.forename: Linda
authors.initials: L
authors.lastname: de Vries
authors.forename: Peter
authors.initials: P
authors.lastname: Andriessen
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy; D003627:Data Interpretation, Statistical; D004569:Electroencephalography / Q000187:drug effects* / Q000706:statistics & numerical data; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007231:Infant, Newborn; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000188:drug therapy; D008012:Lidocaine / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008874:Midazolam / Q000009:adverse effects / Q000627:therapeutic use*; D012640:Seizures / Q000503:physiopathology; D020521:Stroke / Q000150:complications*
chemical_list: D000927:Anticonvulsants; D006993:Hypnotics and Sedatives; D008012:Lidocaine; D008874:Midazolam