{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:42:21Z","timestamp":1780080141867,"version":"3.54.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Mechanisms underlying loss of consciousness following propofol administration remain incompletely understood. The objective of this study was to compare frontal lobe electroencephalography activity and brainstem reflexes during intravenous induction of general anaesthesia, in patients receiving a typical bolus dose (fast infusion) of propofol compared with a slower infusion rate. We sought to determine whether brainstem suppression (\u2018bottom\u2010up\u2019) predominates over loss of cortical function (\u2018top\u2010down\u2019). Sixteen\n                    <jats:styled-content style=\"fixed-case\">ASA<\/jats:styled-content>\n                    physical status\u20101 patients were randomly assigned to either a fast or slow propofol infusion group. Loss of consciousness and brainstem reflexes were assessed every 30\u00a0s by a neurologist blinded to treatment allocation. We performed a multitaper spectral analysis of all electroencephalography data obtained from each participant. Brainstem reflexes were present in all eight patients in the slow infusion group, while being absent in all patients in the fast infusion group, at the moment of loss of consciousness (p\u00a0=\u00a00.010). An increase in alpha band power was observed before loss of consciousness only in participants allocated to the slow infusion group. Alpha band power emerged several minutes after the loss of consciousness in participants allocated to the fast infusion group. Our results show a predominance of \u2018bottom\u2010up\u2019 mechanisms during fast infusion rates and \u2018top\u2010down\u2019 mechanisms during slow infusion rates. The underlying mechanisms by which propofol induces loss of consciousness are potentially influenced by the speed of infusion.\n                  <\/jats:p>","DOI":"10.1111\/anae.14885","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T16:01:08Z","timestamp":1575302468000},"page":"196-201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Differential frontal alpha oscillations and mechanisms underlying loss of consciousness: a comparison between slow and fast propofol infusion rates"],"prefix":"10.1111","volume":"75","author":[{"given":"P.","family":"Sep\u00falveda","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Cl\u00ednica Alemana \u2013 UDD Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. I.","family":"Cortinez","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia School of Medicine Pontificia Universidad Cat\u00f3lica Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Irani","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Division of Neuroscience Pontificia Universidad Cat\u00f3lica Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. I.","family":"Ega\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Peri\u2010operative Medicine Faculty of Medicine Universidad de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Contreras","sequence":"additional","affiliation":[{"name":"Department of Adult and Aging Health School of Nursing Pontificia Universidad Cat\u00f3lica Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"S\u00e1nchez Corzo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Division of Neuroscience Pontificia Universidad Cat\u00f3lica Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Acosta","sequence":"additional","affiliation":[{"name":"Department of Neurology Cl\u00ednica Alemana Santiago de Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sitaram","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Division of Neuroscience Pontificia Universidad Cat\u00f3lica Santiago de Chile"},{"name":"Institute for Biological and Medical Engineering Pontificia Universidad Cat\u00f3lica Santiago de Chile"},{"name":"Center for Brain\u2010Machine Interfaces and Neuromodulation Pontificia Universidad Cat\u00f3lica Santiago de 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