Propofol’s EEG Fast Activity is Dose-Dependent
Chloe B.H. Asato2*, Erica Y. Shin2, Anna K. Gragas2, Keith K. Abe MD, MS1,2 and Loren G. Yamamoto MD, MPH, MBA1,2
1 Kapi`olani Medical Center for Women & Children, Honolulu, Hawaii, USA.
2 Department of Pediatrics, University of Hawai`i John A. Burns School of Medicine, Hawaii, USA.
*Corresponding Author: Chloe B.H Asato, University of Hawaii John A. Burns School of Medicine, Dept. of Pediatrics, Kapi`olani Medical Center for Women and Children, 1319 Punahou Street, #721, Honolulu, Hawai‘i 96826, USA.
DOI: https://doi.org/10.58624/SVOAPD.2023.02.048
Received: September 23, 2023 Published: October 10, 2023
Abstract
Introduction: For patients with a first-time suspected seizure, electroencephalograms (EEG) are part of the initial evaluation. Most sedatives result in EEG artifact “fast activity” (FA), making the EEG difficult to read. During propofol-sedated EEGs, we noticed that FA would diminish when the propofol infusion rate was low. The purpose of this study is to investigate propofol dosing and its relationship to EEG FA artifact.
Methods: This study involved retrospective chart reviews of a pediatric database for sedated EEG encounters in patients under 7 years of age. Data was collected from a total of 55 charts. Total doses of propofol (mg/kg/hr) were calculated for the first half and second half. The actual EEGs were reviewed by a pediatric neurologist study investigator, to classify the degree of FA as: none, mild, moderate, severe. We then examined whether total doses of propofol given during the EEG (mg/kg/hr) halves affected the severity of FA using ordinal logistic regression.
Results: The results are summarized in Table 1, which shows that propofol doses (paired T-test, p<0.001) and EEG FA (Bowker’s test of symmetry, p=0.002) were higher in the first half compared to the second half. Figure 1 graphs each data point independently, which shows via linear and ordinal logistic regression a positive relationship between propofol dosing and FA severity (p=0.0014, OR=1.20, 95% CI=1.08-1.34, respectively).
Conclusion: Fast activity due to propofol appears to be dose-dependent. Lower doses of propofol resulted in less FA on EEG, suggesting that reducing the dose can reduce the FA artifact.
Keywords: Propofol, Electroencephalogram (EEG), EEG fast activity, EEG drug artifact, Procedural sedation.
Citation: Asato CBH, Shin EY, Gragas AK, Abe KK, Yamamoto LG. Propofol’s EEG Fast Activity is Dose-Dependent. SVOA Paediatrics 2023, 2:5, 145-150.