[Concentration-dependent changes in the latency and amplitude of somatosensory-evoked potentials by desflurane, isoflurane and sevoflurane].
OBJECTIVE
Comparison of the influence of desflurane, isoflurane, and sevoflurane on the parameters of cortical somatosensory evoked potentials (SEP).


METHODS
A total of 41 patients were randomly allocated to either the isoflurane, desflurane or sevoflurane group. Following induction with propofol and intubation, concentration of the volatile anaesthetic was kept constant at 1.3, 1.0, and 0.7 MAC for 15 minutes each in randomised sequences. No opioids or N2O were used. Cortical somatosensory evoked potentials were recorded following median nerve stimulation at the wrist with 1.5 times motor threshold current. SEP were evaluated for latencies of peak N20 and P25 as well as peak-to-peak amplitude N20P25. Measurements at the end of the 15 minute equilibration intervals were compared by analysis of variance for repeated measurements. Latencies and the logarithm of the amplitudes were assumed to be normally distributed.


RESULTS
SEP could be recorded in all patients and at all concentrations. Latency of cortical SEP increased with anaesthetic concentration in a linear manner. No differences in latency increase were found between the three anaesthetics (ANOVA). In contrast, the decrease in amplitude with increasing anaesthetic concentration was non-linear. It was large from control to 0.7 MAC, but small in the range between 0.7 and 1.3 MAC. Amplitude reduction was larger with isoflurane than with sevoflurane or desflurane.


CONCLUSIONS
1) Sevoflurane and desflurane are better suited for anaesthetic management during intraoperative electrophysiological monitoring than isoflurane, because SEP amplitudes are better preserved. 2) SEP amplitude is less altered by changing anaesthetic concentrations in the concentration range from 0.7 to 1.3 MAC than SEP latency.
Rehberg
B
B
Klinik und Poliklinik für Anästhesiologie, Universität Bonn.
Rüschner
R
R
Fischer
M
M
Ebeling
B J
BJ
Hoeft
A
A
D000328:Adult; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation; D000077335:Desflurane; D004558:Electric Stimulation; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects*; D005260:Female; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives*; D008297:Male; D008475:Median Nerve / Q000187:drug effects / Q000502:physiology; D008738:Methyl Ethers; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane