title: Effects of adenosine triphosphate (ATP) on somatosensory evoked potentials in humans anesthetized with isoflurane and nitrous oxide.
abstract: In order to examine the usefulness of adenosine triphosphate (ATP) as an adjuvant to anesthesia for surgery requiring intraoperative somatosensory evoked potential (SSEP) monitoring, we have studied the effects of ATP on SSEPs in patients anesthetized with isoflurane and nitrous oxide (N2O). A control recording of SSEP was performed while anesthesia was maintained with 0.5% end-tidal concentration of isoflurane in 60% N2O. The recordings were repeated after an ATP infusion had been added to this basal anesthesia at the rates of 100 micrograms.kg bw-1.min-1 and 200 micrograms.kg bw-1.min-1. SSEP was also studied when end-tidal isoflurane concentration was increased to 1.5% after cessation of ATP infusion. An infusion of ATP combined with 0.5% isoflurane and 60% N2O effectively inhibited an increase in blood pressure during surgery. The amplitude of the cortical component of SSEP was lowered by 1.5% isoflurane, which also increased both cortical and spinal latencies as well as central conduction time (CCT). In contrast ATP infusions at both rates induced no significant changes in latencies, amplitude and CCT. The results indicate that ATP infusion combined with 0.5% isoflurane in 60% N2O can be a useful anesthetic technique for intraoperative SSEP monitoring because adequate anesthetic depth can be maintained by a low concentration of anesthetics without further suppression of SSEPs.
authors.affiliation: Department of Anesthesiology, Yokohama City University School of Medicine, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Andoh
authors.forename: T
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: K
authors.initials: K
authors.lastname: Okazaki
authors.forename: Y
authors.initials: Y
authors.lastname: Okutsu
authors.forename: F
authors.initials: F
authors.lastname: Okumura
mesh_terms: D000255:Adenosine Triphosphate / Q000008:administration & dosage / Q000494:pharmacology*; D000328:Adult; D000368:Aged; D000769:Anesthesia, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D002540:Cerebral Cortex / Q000187:drug effects / Q000502:physiology; D004558:Electric Stimulation; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008475:Median Nerve / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects; D009434:Neural Pathways / Q000187:drug effects / Q000502:physiology; D009609:Nitrous Oxide / Q000008:administration & dosage / Q000494:pharmacology; D011930:Reaction Time / Q000187:drug effects; D013116:Spinal Cord / Q000187:drug effects / Q000502:physiology
chemical_list: D000255:Adenosine Triphosphate; D007530:Isoflurane; D009609:Nitrous Oxide