Amplitude-integrated electroencephalography (aEEG) is being increasingly used to monitor cerebral activity at the bedside in the neonatal intensive care unit (NICU) (7). Widely used scoring systems for aEEG incorporate consideration of background activity, presence of sleep wake cycling (SWC) and seizures (8). There are several aEEG reports indicating that analgesic and sedative agents routinely used in neonates suppress amplitude and therefore alter background activity (9,10,11,12,13) and it is believed that interpretation of aEEG in sedated patients is unreliable. Most of these studies have been conducted investigating pre-term infants or infants with hypoxic-ischaemic encephalopathy.