title: Midlatency auditory evoked potentials during anaesthesia with increasing endexpiratory concentrations of desflurane.
abstract: BACKGROUND
  Under general anaesthesia with the volatile anaesthetics halothane, enflurane and isoflurane, midlatency auditory evoked potentials (MLAEP) are suppressed dose-dependently. Therefore, MLAEP have been used to measure depth of anaesthesia and to indicate intraoperative awareness. Desflurane is a new volatile anaesthetic and its effect on MLAEP have not been studied previously.
  
  
  METHODS
  We have studied MLAEP during general anaesthesia with increasing endexpiratory concentrations of desflurane in 12 patients scheduled for elective gynaecological surgery. Auditory evoked potentials were recorded in the awake state and during anaesthesia with endexpiratory steady state concentrations of 1.5, 3.0, 4.5 and 6.0 vol % of desflurane on vertex (positive) and mastoids on both sides (negative). Latencies of the peaks V, Na, Pa, Nb, Pl (ms) and amplitudes Na/Pa, Pa/Nb and Nb/Pl (micro V) were measured.
  
  
  RESULTS
  In the awake state, MLAEP had high peak-to-peak amplitudes and a periodic waveform. During general anaesthesia with increasing endexpiratory concentration of desflurane, the latency of the brainstem response V increased only slightly. In contrast, MLAEP showed a marked dose-dependent and statistically significant increase in latencies of Na, Pa, Nb and Pl and decrease in amplitudes of Na/Pa, Pa/Nb and Nb/Pl. Under 6.0 vol % of desflurane MLAEP were severely attenuated or even abolished.
  
  
  CONCLUSIONS
  Based on these observations, endexpiratory concentrations of > or = 4.5 vol % desflurane should suppress awareness phenomena such as auditory perceptions during anaesthesia.
authors.affiliation: Institute for Anaesthesiology, University of Munich, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Schwender
authors.forename: S
authors.initials: S
authors.lastname: Klasing
authors.forename: P
authors.initials: P
authors.lastname: Conzen
authors.forename: U
authors.initials: U
authors.lastname: Finsterer
authors.forename: E
authors.initials: E
authors.lastname: Pöppel
authors.forename: K
authors.initials: K
authors.lastname: Peter
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000077335:Desflurane; D004305:Dose-Response Relationship, Drug; D005072:Evoked Potentials, Auditory / Q000187:drug effects*; D016057:Evoked Potentials, Auditory, Brain Stem / Q000187:drug effects; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D008875:Middle Aged; D012119:Respiration
chemical_list: D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane