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BJA Advance Access published online on September 12, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen269
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Hyperventilation-induced hypocapnia changes the pattern of electroencephalographic bicoherence growth during sevoflurane anaesthesia

K. Hayashi1,*, M. Fujikawa1 and T. Sawa1,2

1 Department of Anesthesiology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kamigyo-ku, Kyoto 602-0841, Japan
2 Department of Anesthesiology, Kyoto First Red Cross Hospital, Kyoto, Japan

* Corresponding author. E-mail: zukko{at}koto.kpu-m.ac.jp

Background: Hyperventilation, with the resulting hypocapnia, reduces cerebral blood flow and causes slowing of the EEG activity. However, neuronal oscillating properties including the thalamocortical network during hyperventilation have not been elucidated. To assess these features provoked by hyperventilation, the present study examined quadratic phase coupling features by means of bicoherence analysis.

Methods: Twenty-two patients were anaesthetized using sevoflurane 1.5% combined with remifentanil or epidural anaesthesia. After a stable normocapnic period, hypocapnia was induced by hyperventilation, and the raw EEG signals were collected. Bispectral analysis (bicoherence) and power spectrum analysis were performed before and after hypocapnia.

Results: Mean (SD) peak bicoherence in the {delta}–{theta} area increased from 35.6 (10.9)% during normocapnia to 43.8 (10.9)% during hypocapnia (P<0.05), whereas mean (SD) peak bicoherence in the {alpha} area decreased from 42.8 (14.4)% during normocapnia to 37.5 (12.3)% during hypocapnia (P<0.05). Normalized power in the {delta}–{theta} frequencies on the power spectrum increased from 60.2 (13.1)% to 72.5 (12.7)% (P<0.05). Bispectral index and spectral edge frequency changed from 45.9 (7.0) to 40.1 (5.6) (P<0.05) and from 15.0 (2.3) to 14.0 (2.5) Hz (P<0.05), respectively. No significant differences in these values were observed between the two types of anaesthesia.

Conclusions: Hypocapnia enlarged bicoherence growth in the {delta}–{theta} frequency range, suggesting the contribution of subcortical oscillating mechanisms in regulating EEG during hyperventilation.

Keywords: brain, electroencephalography; brain, hypothalamus; ventilation, hyperventilation


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