• Sebastian J Corlette, Suellen M Walker, Laura Cornelissen, Christopher Brasher, Janeen Bower, and Andrew J Davidson.
• Department of Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia; and Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
• Anesthesiology. 2024 Oct 1; 141 (4): 670680670-680.

BackgroundAlthough effects of general anesthesia on neuronal activity in the human neonatal brain are incompletely understood, electroencephalography provides some insight and may identify age-dependent differences.MethodsA systematic search (MEDLINE, Embase, PubMed, and Cochrane Library to November 2023) retrieved English language publications reporting electroencephalography during general anesthesia for cardiac or noncardiac surgery in term neonates (37 to 44 weeks postmenstrual age). Data were extracted, and risk of bias (ROBINS-I Cochrane tool) and quality of evidence (Grading of Recommendations Assessment, Development, and Evaluation [GRADE] checklist) were assessed.ResultsFrom 1,155 abstracts, 9 publications (140 neonates; 55% male) fulfilled eligibility criteria. Data were limited, and study quality was very low. The occurrence of discontinuity, a characteristic pattern of alternating higher and lower amplitude electroencephalography segments, was reported with general anesthesia (94 of 119 neonates, 6 publications) and with hypothermia (23 of 23 neonates, 2 publications). Decreased power in the delta (0.5 to 4 Hz) frequency range was also reported with increasing anesthetic dose (22 neonates; 3 publications).ConclusionAlthough evidence gaps were identified, both increasing sevoflurane concentration and decreasing temperature are associated with increasing discontinuity.Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc., on behalf of the American Society of Anesthesiologists.

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