title: The effects of isoflurane and desflurane titrated to a bispectral index of 60 on the cortical somatosensory evoked potential during pediatric scoliosis surgery.
abstract: In this study, we compared the effect of isoflurane and desflurane on the posterior tibial somatosensory evoked potential recorded by scalp electrodes during correction of idiopathic scoliosis in pediatric patients. Depth of sedation was controlled by maintaining bispectral index (BIS) at 60 throughout the study. Comparison of patients breathing desflurane and isoflurane showed an evoked cortical amplitude (N37-P45) of 0.53 +/- 0.3 microV versus 1.3 +/- 0.8 microV (P = 0.014), respectively. In addition to this comparison, a crossover design was included whereby the desflurane or isoflurane received in the first part of the study was changed to the other anesthetic. Substituting one anesthetic for another confirmed our initial finding that the cortical evoked amplitude is greater with isoflurane than with desflurane. No differential effect was found between desflurane and isoflurane on the evoked subcortical (N31-P34) amplitude or the P37 latency.
authors.affiliation: *Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and †Department of Anesthesiology, Children's Hospital Buffalo, Buffalo, New York.
authors.forename: James E
authors.initials: JE
authors.lastname: Fletcher
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hinn
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Heard
authors.forename: Linda S
authors.initials: LS
authors.lastname: Georges
authors.forename: Eugene B
authors.initials: EB
authors.lastname: Freid
authors.forename: Ann
authors.initials: A
authors.lastname: Keifer
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Brooks
authors.forename: Ann G
authors.initials: AG
authors.lastname: Bailey
authors.forename: Robert D
authors.initials: RD
authors.lastname: Valley
mesh_terms: D000293:Adolescent; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001831:Body Temperature / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D000077335:Desflurane; D004558:Electric Stimulation; D004569:Electroencephalography / Q000187:drug effects*; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D016343:Monitoring, Intraoperative; D019637:Orthopedic Procedures; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery*; D013979:Tibial Nerve / Q000502:physiology
chemical_list: D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane