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271909

Utility of Neonatal Pain, Agitation and Sedation Scale and Amplitude Integrated Electroencephalogram to Differentiate the Different Levels of Sedation in Neonatal Intensive Care

Article

Last updated: 03 Jan 2025

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Abstract

Background: Neonates admitted in any Neonatal Intensive Care Unit (NICU) are constantly subjected to several stressful and painful conditions and require pain and sedation management. Ineffective sedation has severe consequences. Excessive sedation can prolong the duration of mechanical ventilation. On the other hand, inadequate sedation may lead to asynchronization with the ventilator and inability of adequate ventilation. The objective of the current study is to evaluate the use of Neonatal Pain, Agitation and Sedation Scale (N-PASS) parameters and double channel amplitude integrated electroencephalography (aEEG) to differentiate between light and deep sedation in neonatal patients. Patients and methods: A total of 30 full term neonates mechanically ventilated with congenital pneumonia were recruited for the current study. Neonates of the study were divided into 2 groups according to the dose of sedative received into Lightly sedated group and Deeply sedated. All studied neonates were subjected toN-PASS and aEEG monitoring before starting sedation and after 2 hours of sedation. Results: Parameters of Burdjalov score (Continuity, Cycling, bandwidth span) and its total score showed a statistically significant decrease after sedation with median in the in non-sedated patients than deeply sedated patients (12 (11 - 12) vs. 8 (8 - 9), respectively (p < 0.001).There was also a difference which was statistically significant between deeply sedated patients than lightly sedated patients [8 (7 - 8) vs. 9 (9 - 9), respectively (p < 0.00)]. When applying ROC analysis, aEEG total (Burdjalov) score at a cut-off value of ≤8 was predictive of deep sedation with 100% sensitivity and specificity. Conclusion: aEEG can be used to differentiate between states of awake and sedation, and can also be used to differentiate the different sedation levels.    

DOI

10.21608/ejhm.2022.271909

Keywords

Neonate, Sedation levels, Amplitude integrated electroencephalogram, NICU, aEEG, Pain, Burdjalov score, Ain Shams university

Authors

First Name

mariam

Last Name

ibrahim

MiddleName

-

Affiliation

pediatrics department ain shams university

Email

mariam.john@med.asu.edu.eg

City

cairo

Orcid

0000-0002-4936-8303

First Name

Nehal

Last Name

El Raggal

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

Mohamed

Last Name

Dawoud

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

Bassem

Last Name

Mohamed

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

Maha

Last Name

Mohammed

MiddleName

-

Affiliation

-

Email

mahazakariya@med.asu.edu.eg

City

-

Orcid

0000-0002-6098-561X

Volume

89

Article Issue

2

Related Issue

37472

Issue Date

2022-10-01

Receive Date

2022-11-30

Publish Date

2022-10-01

Page Start

6,902

Page End

6,907

Print ISSN

1687-2002

Online ISSN

2090-7125

Link

https://ejhm.journals.ekb.eg/article_271909.html

Detail API

https://ejhm.journals.ekb.eg/service?article_code=271909

Order

123

Type

Original Article

Type Code

606

Publication Type

Journal

Publication Title

The Egyptian Journal of Hospital Medicine

Publication Link

https://ejhm.journals.ekb.eg/

MainTitle

Utility of Neonatal Pain, Agitation and Sedation Scale and Amplitude Integrated Electroencephalogram to Differentiate the Different Levels of Sedation in Neonatal Intensive Care

Details

Type

Article

Created At

22 Jan 2023