Resting State EEG Characteristics During Sedation With Midazolam or Propofol in Older Subjects

Background. Despite widespread application, little is known about the neurophysiological effects of light sedation with midazolam or propofol, particularly in older subjects. The aim of this study was to assess the effects of light sedation with midazolam or propofol on a variety of EEG measures in older subjects. Methods. In patients (≥60 years without neuropsychiatric disease such as delirium), 2 EEG recordings were performed, before and after administration of either midazolam (n = 22) or propofol (n = 26) to facilitate an endoscopic procedure. Power spectrum, functional connectivity, and network topology based on the minimum spanning tree (MST) were compared within subjects. Results. Midazolam and propofol administration resulted in Richmond Agitation and Sedation Scale levels between 0 and -4 and between -2 and -4, respectively. Both agents altered the power spectra with increased delta (0.5-4 Hz) and decreased alpha (8-13 Hz) power. Only propofol was found to significantly reduce functional connectivity. In the beta frequency band, the MST was more integrated during midazolam sedation. Propofol sedation resulted in a less integrated network in the alpha frequency band. Conclusion. Despite the different levels of light sedation with midazolam and propofol, similar changes in power were found. Functional connectivity and network topology showed differences between midazolam and propofol sedation. Future research should establish if these differences are caused by the different levels of sedation or the mechanism of action of these agents.