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

Published online by Cambridge University Press:  01 July 2007

T. Musialowicz ,
M. Niskanen ,
H. Yppärilä-Wolters ,
M. Pöyhönen ,
O. Pitkänen  and
M. Hynynen
T. Musialowicz*
Affiliation:
Kuopio University Hospital, Anaesthesiology and Intensive Care Department, Kuopio, Finland
M. Niskanen
Affiliation:
Kuopio University Hospital, Anaesthesiology and Intensive Care Department, Kuopio, Finland
H. Yppärilä-Wolters
Affiliation:
Kuopio University Hospital, Department of Neurophysiology, Kuopio, Finland
M. Pöyhönen
Affiliation:
Kuopio University Hospital, Anaesthesiology and Intensive Care Department, Kuopio, Finland
O. Pitkänen
Affiliation:
Kuopio University Hospital, Anaesthesiology and Intensive Care Department, Kuopio, Finland
M. Hynynen
Affiliation:
Helsinki University Hospital, Jorvi Hospital – Department of Anaesthesiology and Intensive Care, Espoo, Finland
*
Correspondence to: Tadeusz Musialowicz, Anaesthesiology and IntensiveCare Department, Kuopio University Hospital, Puijonlaaksontie 2, P. O. Box 1777, Kuopio 70211, Finland. E-mail: tadeusz.musialowicz@kuh.fi; Tel: +35817173351; Fax: +35817173351
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Summary

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.

Keywords

ANAESTHESIA, inhalation, intravenousCARDIOPULMONARY BYPASSAUDITORY EVOKED POTENTIALSELECTROENCEPHALOGRAPHY, bispectral index
Type
EACTA Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 7 , July 2007 , pp. 571 - 579
Copyright
Copyright © European Society of Anaesthesiology 2007

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