British Journal of Anaesthesia, Vol 77, Issue 5 617-624, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
NAM. de Beer, J. C. van Hooff, CHM. Brunia, PJM. Cluitmans, HHM. Korsten and JEW. Beneken
We tested the hypothesis that midlatency auditory evoked potentials (MLAEP)
can predict the occurrence of long latency AEP components (LLAEP), which
are taken as evidence for perceptual processing. Forty- one patients
undergoing cardiac surgery were anaesthetized with propofol and alfentanil.
During several periods of surgery we recorded LLAEP. Peak-to-peak amplitude
measures were used to determine if a particular LLAEP recording trace
contained a recognizable waveform. Both before and after each LLAEP
recording epoch, MLAEP and the spontaneous electroencephalogram (EEG) were
recorded. Peak latencies and amplitudes of brainstem peak V and midlatency
peaks Na, Pa, Nb, Pb and Nc, characteristic frequencies from the
spontaneous EEG, mean arterial pressure (MAP) and nasopharyngeal
temperature (7) were compared between recording epochs with and without
clear LLAEP waveforms. These variables were also used in a discriminant
analysis to predict the occurrence of an LLAEP waveform. Pa and Nb
latencies were significantly shorter both before and after recording epochs
in which an LLAEP waveform occurred, compared with epochs in which no LLAEP
waveform occurred. Using a combination of up to six EEG, MLAEP, MAP and T
measures, it was possible to predict the occurrence or absence of an LLAEP
waveform with a sensitivity of 89% and specificity of 86%. We conclude that
MLAEP components provide information on the possibility of perceptual
processing during general anaesthesia, and thus may be relevant for
monitoring depth of anaesthesia.
CLINICAL INVESTIGATIONS
Midlatency auditory evoked potentials as indicators of perceptual processing during general anaesthesia
Department of Medical Electrical Engineering, Eindhoven University of Technology, PO Box 513, 5600 MB Eindhoven, The Netherlands; Section of Psychonomics, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands; Department of Anaesthesiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven, The Netherlands
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