A center comparison found different cerebral oxygenation and EEG patterns under midazolam-based and sevoflurane-based care. The groups differed beyond anesthetic choice.
Neonates undergoing diaphragmatic-hernia repair had brain oxygenation and activity measured. The sevoflurane group showed higher regional oxygenation and greater suppression of some EEG activity measures.
The midazolam group was more critically ill, included more severe defects, and was operated on in a different care setting. Medicines were compared by administered dose rather than measured concentration.
A center comparison cannot separate regimen, disease severity, location, technique, and other clinical decisions as a randomized drug trial would. The authors identified those limitations.
EEG power and oxygenation are not direct reports of conscious pain or awareness. Findings that suggest inadequate conditions require clinical interpretation rather than a definitive claim from one signal. The paper supports examining combined monitoring and illness context, but cannot establish that midazolam alone caused hypoxia or that every patient experienced awareness.
Original analysis of the supplied journal article, identified as PMC8718750.