Auditory-evoked potentials in bispectral index-guided anaesthesia for cardiac surgery.

Full Abstract

BACKGROUND

AND OBJECTIVE:
Midlatency auditory-evoked potentials, as measures of the anaesthetic state, were evaluated at similar levels of bispectral index in cardiac surgical patients maintained with either propofol or isoflurane anaesthesia.

METHODS:
Twenty-four patients were randomly allocated to anaesthesia with propofol (n = 12) or isoflurane (n = 12). Bispectral index was maintained below 60 during surgery. Auditory-evoked potentials were collected before induction of anaesthesia, 10 min after intubation, 30 min after sternotomy, during cardiopulmonary bypass at the time of cross-clamping of the aorta and during stable mild hypothermia, after de-clamping of the aorta, and after the operation.

RESULTS:
At the pre-determined time points, bispectral index values showed comparable depth of hypnosis in both groups. The latency of the Nb component of midlatency auditory-evoked potentials was significantly increased in the isoflurane group after intubation (P < 0.001) and that of both the Nb and the Pa components after sternotomy (P < 0.001) compared with the propofol group. No differences between the groups were detected with respect to haemodynamic variables. No patient reported recall of intraoperative events.CONCLUSION:
After intubation and surgical stimulation, when bispectral index was at a constant level, there was a difference in the Nb and Pa components of the midlatency auditory-evoked potentials between the two anaesthetic regimens, indicating a distinction in the state of anaesthesia. Our results suggest that the parallel use of these two electrophysiological methods can show differences in the components of anaesthesia between various anaesthesia methods in cardiac surgical patients.

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Author information

Author/s: Musialowicz, T (T); Niskanen, M (M); Yppärilä-Wolters, H (H); Pöyhönen, M (M); Pitkänen, O (O); Hynynen, M (M);

Affiliation: Kuopio University Hospital, Anaesthesiology and Intensive Care Department, Kuopio, Finland. tadeusz.musialowicz(-atsign-)kuh.fi

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: European journal of anaesthesiology (Eur J Anaesthesiol), published in England. (Language: eng)

Reference: 2007-Jul; vol 24 (issue 7) : pp 571-9

Dates: Created 2007/06/14; Completed 2007/07/31;

PMID: 17462117, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Alfentanil - pharmacology
Anesthesia, General
Anesthetics, Combined - pharmacology
Anesthetics, Inhalation - pharmacology
Anesthetics, Intravenous - pharmacology
Blood Pressure - drug effects
Cardiopulmonary Bypass
Consciousness - drug effects
Coronary Artery Bypass
Electroencephalography
Evoked Potentials, Auditory - drug effects

Evoked Potentials, Auditory - drug effects
Female
Heart Rate - drug effects
Humans
Isoflurane - pharmacology
Male
Memory - drug effects
Middle Aged
Monitoring, Intraoperative - methods
Propofol - pharmacology
Reaction Time - drug effects
Time Factors

Associated Chemicals: Anesthetics, Combined (0) ; Anesthetics, Inhalation (0) ; Anesthetics, Intravenous (0) ; Propofol (2078-54-8) ; Isoflurane (26675-46-7) ; Alfentanil (71195-58-9)

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