Preoperative Beta and Gamma EEG Spectral Power as Independent Predictors of Acute Postoperative Pain in Spinal Surgery: A Prospective Observational Cohort Study

Hui Wu,1– 4,* Meiyan Zhou,2,* Songtao Liu,2,* Yu Qi,2 Fan Zhou,1– 4 Liwei Wang,1,2 Conghai Fan1,3,4 1College of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 2Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou, Jiangsu, People’s Republic of China; 3Jiangsu Province Key Laboratory of Anesthesioloy and Brain Science, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China; 4Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Liwei Wang, College of Anesthesiology, Xuzhou Medical University, No. 199 Jiefang South Road Quanshan District, Xuzhou, Jiangsu, 221009, People’s Republic of China, Tel +8618952170255, Email doctorlww@sina.com Conghai Fan, College of Anesthesiology, Xuzhou Medical University, No. 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu, 221004, People’s Republic of China, Tel +8613013983238, Email FGYXhao@163.comPurpose: The purpose of this paper was to explore the relationship between preoperative EEG frequency band characteristics and postoperative acute pain in patients undergoing spinal surgery, in order to provide a scientific basis for personalized pain management.Methods: The study included 78 patients undergoing spinal surgery under general anesthesia. Two hours before surgery, the resting EEG of the patients was collected for 10 minutes with eyes closed and relaxed, and the power spectrum characteristics of different frequency bands were extracted by time-frequency analysis. Collected pain scores, anxiety and sleep scales of all patients before and after surgery. Combined with statistical analysis methods for data processing, the correlation between preoperative EEG frequency band power and postoperative pain was explored.Results: Our study revealed that preoperative beta and gamma power in patients undergoing spinal surgery were negatively correlated with postoperative pain and demonstrated significant predictive value for pain outcomes (β: ρ = − 0.84, P< 0.001; γ: ρ = − 0.85, P< 0.001). Notably, γ-band due to their specific association with the temporal-insular network, exhibited the most robust predictive efficacy. Furthermore, preoperative β-band and γ-band were also negatively correlated with postoperative anxiety and sleep quality.Conclusion: Preoperative β and γ oscillations represent promising neurophysiological correlates of acute pain susceptibility following spine surgery. Our findings suggest that these EEG metrics could serve as one of the components in a future multi-factorial predictive model for personalized pain management. However, given the multifactorial nature of pain and the lack of validated clinical thresholds, further research is required to establish their practical utility in guiding perioperative analgesic strategies. Future studies should focus on integrating these EEG biomarkers with psychological and clinical assessments to develop robust prediction tools.Keywords: electroencephalogram, acute pain, spinal surgery, pain prediction