Dexmedetomidine produces more sleep-like brain activity compared with propofol in human participants

Bryan M Krause; Emily R Dappen; Rashmi N Mueller; Hiroto Kawasaki; Robert D Sanders; Kirill V Nourski; Matthew I Banks

doi:10.1016/j.bja.2025.09.050

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Dexmedetomidine produces more sleep-like brain activity compared with propofol in human participants

Journal article

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Dexmedetomidine produces more sleep-like brain activity compared with propofol in human participants

Bryan M Krause, Emily R Dappen, Rashmi N Mueller, Hiroto Kawasaki, Robert D Sanders, Kirill V Nourski and Matthew I Banks

British journal of anaesthesia : BJA, Vol.136(2), pp.552-563

02/2026

DOI: 10.1016/j.bja.2025.09.050

PMCID: PMC12668097

PMID: 41203472

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Abstract

Dexmedetomidine is a selective α -adrenergic agonist used as an anaesthesia adjunct to produce a state of sleep-like sedation. How brain activity compares quantitatively during dexmedetomidine anaesthesia with that during natural sleep remains unclear. We have shown that the general anaesthetic propofol is associated with changes in connectivity and cortical network structure similar to sleep. Here, we compare quantitatively the effects of dexmedetomidine, propofol, and sleep on brain activity. Intracranial encephalography recordings were obtained in 34 patients with epilepsy being evaluated for seizure resection surgery. Band power, functional connectivity, and network entropy were measured during task-free periods just before surgery, during anaesthesia with either dexmedetomidine or propofol, and during overnight sleep. Anaesthesia stage (wake, sedated, unresponsive) was determined using the Observer's Assessment of Arousal/Sedation. Sleep was staged using standard polysomnography. Significant differences in delta power were observed during dexmedetomidine and propofol anaesthesia and during sleep. However, the magnitude of changes in delta power was smaller and regionally heterogeneous for propofol compared with dexmedetomidine and sleep, whereas changes in network entropy were larger for propofol compared with dexmedetomidine and sleep. Quantitative comparisons between changes in delta power and network entropy suggest that unresponsiveness under dexmedetomidine anaesthesia produces a similar brain state to that observed during N2 sleep. Although delta power, functional connectivity, and network entropy all showed changes during propofol, dexmedetomidine, and sleep, the magnitudes of these changes suggest that the effects of dexmedetomidine are more similar than those of propofol to sleep, specifically to N2 sleep.

sleep

intracranial electrophysiology

cortical networks

dexmedetomidine

functional connectivity

propofol

Details

Title: Subtitle: Dexmedetomidine produces more sleep-like brain activity compared with propofol in human participants
Creators: Bryan M Krause - University of Wisconsin–Madison
Emily R Dappen - University of Iowa
Rashmi N Mueller - University of Iowa
Hiroto Kawasaki - University of Iowa
Robert D Sanders - The University of Sydney
Kirill V Nourski - University of Iowa
Matthew I Banks - University of Wisconsin–Madison
Resource Type: Journal article
Publication Details: British journal of anaesthesia : BJA, Vol.136(2), pp.552-563
DOI: 10.1016/j.bja.2025.09.050
PMID: 41203472
PMCID: PMC12668097
NLM abbreviation: Br J Anaesth
ISSN: 1471-6771
eISSN: 1471-6771
Publisher: Elsevier
Grant note: US National Institutes of Health: R01-DC004290, R01-GM109086 University of Wisconsin Department of Anesthesiology
US National Institutes of Health (grants R01-DC004290 and R01-GM109086) ; the University of Wisconsin Department of Anesthesiology.
Language: English
Electronic publication date: 11/06/2025
Date published: 02/2026
Academic Unit: Iowa Neuroscience Institute; Anesthesia; Neurosurgery
Record Identifier: 9985024256402771

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