Brain Activity and Changes in Consciousness During General Anesthesia

September 19, 2026 updated by: Beijing Chao Yang Hospital

Mechanism Exploration of General Anesthesia-Induced Altered Consciousness Via Cortical-Thalamic Network Modulation and Development of a Precision Anesthesia Depth Monitoring Device

This study aims to investigate how general anesthetics alter brain activity and consciousness across different age groups. The study will evaluate four anesthetic agents with different mechanisms of action: propofol, remimazolam, esketamine, and dexmedetomidine. Electroencephalography (EEG) will be recorded during wakefulness, anesthetic induction, loss of responsiveness, and recovery of responsiveness to characterize changes in brain activity and brain network dynamics.

The study includes children aged 6-12 years undergoing surgery, healthy young adults aged 20-40 years, and healthy older adults aged 65-80 years. Resting-state EEG will be used to examine changes in brain rhythms, temporal and spatial brain dynamics, and network organization across different levels of consciousness. In a subgroup of young adult participants, auditory stimuli will also be presented continuously to investigate how the brain processes sounds and meaningful information as consciousness decreases and subsequently recovers.

The study will compare EEG changes across anesthetic agents, age groups, and states of consciousness. It will also evaluate the timing of loss and recovery of responsiveness, anesthetic dose-response relationships, and adverse events. The overall goal is to identify brain activity patterns associated with anesthesia-induced changes in consciousness and to provide a scientific basis for improved monitoring of consciousness and anesthetic depth.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

320

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Beijing, China, 100020
        • Affiliated Beijing Chaoyang Hospital of Capital Medical University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

6 years to 80 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Participants must belong to one of the following prespecified age groups: children aged 6-12 years, young adults aged 20-40 years, or older adults aged 65-80 years.
  2. Children must be surgical patients undergoing general anesthesia. Young adult and older adult participants will be healthy volunteers.
  3. American Society of Anesthesiologists (ASA) physical status I; older adult participants may have ASA physical status II.
  4. Written informed consent must be obtained from all adult participants and surgical patients as applicable. For pediatric participants, written informed consent must be provided by a parent or legal guardian.

Exclusion Criteria:

  1. History of neuropsychiatric disorders, including epilepsy, dementia, or other relevant neurological or psychiatric diseases.
  2. Known hearing impairment or physical impairment that may interfere with completion of the study procedures or tasks.
  3. History of allergy to propofol, benzodiazepines, or other anesthetic agents used in the study.
  4. Long-term use of sedative or analgesic medications for more than 1 month. Disturbed sleep pattern within 14 days before the study, including shift work or insomnia.
  5. Communication difficulties or inability to cooperate with EEG data acquisition.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Propofol Group

Participants in this arm will receive propofol. In young and older healthy volunteers, propofol will be administered by target-controlled infusion, with the plasma target concentration increased by 0.5 μg/mL every 5 minutes up to a maximum of 5 μg/mL to induce loss of responsiveness. EEG will be recorded during wakefulness, anesthetic induction, loss of responsiveness, and recovery. Pediatric surgical participants in this group will undergo EEG recording during anesthesia in the operating room.

Propofol will be administered by target-controlled infusion in young and older healthy volunteers. The plasma target concentration will be increased by 0.5 μg/mL every 5 minutes, up to a maximum of 5 μg/mL, until protocol-defined loss of responsiveness is achieved. Consciousness will be assessed every minute using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale, and EEG will be recorded throughout anesthetic induction and recovery.

Experimental: Remimazolam Group

Participants in this arm will receive remimazolam. In young and older healthy volunteers, remimazolam will be administered intravenously at sequential infusion rates of 0.5, 1.0, 1.5, and 2.0 mg/kg/h, with each level maintained for 5 minutes, until loss of responsiveness is achieved. EEG will be recorded during wakefulness, anesthetic induction, loss of responsiveness, and recovery. Pediatric surgical participants in this group will undergo EEG recording during anesthesia in the operating room.

Remimazolam will be administered intravenously in young and older healthy volunteers at sequential infusion rates of 0.5, 1.0, 1.5, and 2.0 mg/kg/h, with each level maintained for 5 minutes, until protocol-defined loss of responsiveness is achieved. Consciousness will be assessed every minute using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale, and EEG will be recorded throughout anesthetic induction and recovery.

Experimental: Esketamine Group

Participants in this arm will receive esketamine. In young and older healthy volunteers, esketamine will be administered intravenously with the infusion rate increased by 0.10 mg/kg/h every 5 minutes, up to a maximum of 0.50 mg/kg/h, to induce loss of responsiveness. EEG will be recorded during wakefulness, anesthetic induction, loss of responsiveness, and recovery. Pediatric surgical participants in this group will undergo EEG recording during anesthesia in the operating room.

Esketamine will be administered intravenously in young and older healthy volunteers. The infusion rate will be increased by 0.10 mg/kg/h every 5 minutes, up to a maximum of 0.50 mg/kg/h, until protocol-defined loss of responsiveness is achieved. Consciousness will be assessed every minute using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale, and EEG will be recorded throughout anesthetic induction and recovery.

Experimental: Dexmedetomidine Group

Participants in this arm will receive dexmedetomidine. In young and older healthy volunteers, dexmedetomidine will be administered intravenously with stepwise increases of 0.1 μg/kg/h, up to a maximum of 0.7 μg/kg/h, to induce loss of responsiveness. EEG will be recorded during wakefulness, anesthetic induction, loss of responsiveness, and recovery. Pediatric surgical participants in this group will undergo EEG recording during anesthesia in the operating room.

Dexmedetomidine will be administered intravenously in young and older healthy volunteers with stepwise increases in the infusion rate of 0.1 μg/kg/h, up to a maximum of 0.7 μg/kg/h, until protocol-defined loss of responsiveness is achieved. Consciousness will be assessed every minute using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale, and EEG will be recorded throughout anesthetic induction and recovery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in Resting-State Quantitative EEG Measures Across Behavioral Responsiveness States
Time Frame: From the start of the 10-minute awake baseline through anesthetic induction, loss-of-responsiveness maintenance, emergence, and 30 minutes after recovery of responsiveness

Continuous resting-state EEG will be quantified across awake baseline, anesthetic induction, loss of responsiveness, maintenance, emergence, and recovery. Prespecified measures include delta power (0.5-4 Hz), alpha power (8-12 Hz), theta/alpha power ratio, slow-wave index (SWI), burst suppression ratio (BSR), autocorrelation window at the first zero crossing (ACW-0), EEG complexity (gMLZC), and alpha-band (8-13 Hz) functional connectivity/network measures, including wPLI/dwPLI² and weighted global efficiency. Each measure will be analyzed separately.

From the start of the 10-minute awake baseline through anesthetic induction, loss-of-responsiveness maintenance, emergence, and 30 minutes after recovery of responsiveness
Changes in Auditory-Evoked ERP and Time-Frequency EEG Measures Across Behavioral Responsiveness States
Time Frame: From the start of the 10-minute awake baseline through anesthetic induction, loss of responsiveness, maintenance, emergence, and at least 10 minutes after recovery of responsiveness

Auditory-evoked EEG will be quantified across awake baseline, anesthetic induction, loss of responsiveness, maintenance, emergence, and recovery. Event-related potential (ERP) measures include N100, mismatch negativity (MMN), N400, and P300 amplitudes and their state-related temporal dynamics. Stimuli include pure tones, white noise, characters, words, sentences, another person's name, and the participant's own name. Time-frequency measures include event-related theta-band activity (4-8 Hz), alpha-band activity (8-12 Hz), and intertrial phase coherence. Source-space analyses will localize N400 and P300 generators, and single-trial ERP amplitudes will be analyzed in relation to behavioral responsiveness. Each measure will be analyzed separately.

From the start of the 10-minute awake baseline through anesthetic induction, loss of responsiveness, maintenance, emergence, and at least 10 minutes after recovery of responsiveness

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 1, 2026

Primary Completion (Estimated)

September 1, 2028

Study Completion (Estimated)

December 1, 2028

Study Registration Dates

First Submitted

September 4, 2026

First Submitted That Met QC Criteria

September 19, 2026

First Posted (Actual)

September 23, 2026

Study Record Updates

Last Update Posted (Actual)

September 23, 2026

Last Update Submitted That Met QC Criteria

September 19, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 2026-ke-429
  • L2510005 (Other Grant/Funding Number: Beijing Natural Science Foundation - Capital Clinical Medical Innovation Joint Fund)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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