title: Equi-MAC concentrations of halothane and isoflurane do not produce similar bispectral index values.
abstract: Minimum alveolar concentration (MAC) has been traditionally used to measure the potency of an inhalational anesthetic agent. Recently, bispectral index (BIS) derived from the frontal cortical electroencephalogram has been used frequently for quantifying the hypnotic component of anesthesia. The present study was designed to examine the BIS values produced by equi-MAC concentrations of halothane and isoflurane. In 34 patients undergoing spinal surgery, BIS and spectral edge frequency (SEF95) were recorded at 3 different concentrations of halothane and isoflurane--namely 0.5, 0.75, and 1.0 MAC. The measurements were made both during wash-in and wash-out phases of the anesthetic agent. Eighteen patients received halothane and 16 received isoflurane. Heart rate, mean arterial pressure, oxygen saturation, and end tidal carbon dioxide pressure values were not different between the 2 groups at various MAC concentrations of the anesthetic agents. BIS and SEF95 values decreased significantly with increasing concentrations of both the anesthetic agents (P<0.001). At any given MAC concentration of the anesthetic, BIS and SEF(95) values were significantly lower under isoflurane compared with halothane anesthesia both during wash-in and wash-out phases (P<0.001). For a given anesthetic agent, BIS values were comparable at equi-MAC concentrations during wash-in and wash-out phases. In conclusion, BIS values are significantly lower under isoflurane compared with halothane anesthesia at similar MAC concentrations. For a given anesthetic agent and a given MAC concentration, the BIS values are similar during wash-in and wash-out phases of anesthesia.
authors.affiliation: Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences, Bangalore, India. gsuma@nimhans.kar.nic.in
authors.forename: Ganne S
authors.initials: GS
authors.lastname: Umamaheswara Rao
authors.forename: Zulfiqar
authors.initials: Z
authors.lastname: Ali
authors.forename: Madhusudan
authors.initials: M
authors.lastname: Ramamoorthy
authors.forename: Jayaprakash
authors.initials: J
authors.lastname: Patil
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D001794:Blood Pressure / Q000187:drug effects; D004569:Electroencephalography / Q000187:drug effects*; D005260:Female; D006221:Halothane / Q000008:administration & dosage / Q000493:pharmacokinetics; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage / Q000493:pharmacokinetics; D008297:Male; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures; D011650:Pulmonary Alveoli / Q000378:metabolism*; D013131:Spine / Q000601:surgery
chemical_list: D007530:Isoflurane; D006221:Halothane