Author(s): Tinker JH, Sharbrough FW, Michenfelder JD
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Abstract EEG amplitude dominance in awake man is posterior. During EEG monitoring in patients, the authors observed the abrupt appearance of anterior amplitude dominance during induction of anesthesia with halothane, enflurane, or thiopental. This EEG change is coincident with loss of eyelid reflex and loss of ability to respond to command. This EEG change was studied with several anesthetics in five Java monkeys to determine alveolar anesthetic concentration at which it occurred and to observe the effects of various stimuli on it. EEG recordings were obtained after equilibration at each level with increasing concentrations of halothane, enflurane or isoflurane in oxygen and each agent again in 30 per cent N2O, in separate experiments in the same animals. EEG amplitude dominance became anterior in each animal with each anesthetic and combination at concentrations less than MAC, which was also determined in the same experiments. At lower concentrations, stimulation at equilibrated anesthetic concentrations resulted in abrupt EEG return to posterior amplitude dominance. The end-tidal anesthetic concentration at which persistence of anterior EEG dominance was seen after stimulation was approximately 0.4 MAC for each anesthetic and combination tested. This is interpreted as support for physical solution-lipid solubility theories of anesthetic action. In addition, an EEG change common to various anesthetics may increase the clinical usefulness of EEG monitoring. It is speculated that this EEG change may signal loss of awareness. If so, observance of sustained anterior EEG amplitude dominance may provide assurance of obliteration of awareness during anesthesia.
This article was published in Anesthesiology
and referenced in International Journal of Neurorehabilitation