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British Journal of Anaesthesia, 2001, Vol. 86, No. 3 354-360
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Biphasic EEG changes in relation to loss of consciousness during induction with thiopental, propofol, etomidate, midazolam or sevoflurane

K. Kuizenga1, J. M. K. H. Wierda1 and C. J. Kalkman2

1Department of Anesthesiology, University Hospital of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. 2Department of Anesthesiology, University Medical Centre Utrecht, Heidelberglaan 100, PO Box 85500, 3508 GA Utrecht, The Netherlands*Corresponding author

The time course of four EEG effect variables, amplitude in the 2–5 Hz and in the 11–15 Hz band, spectral edge frequency 95% (SEF95), and bispectral index (BIS), in response to increasing concentrations of thiopental, propofol, etomidate, midazolam, or sevoflurane during a 10 min induction of anaesthesia was studied in 25 patients to determine the existence of a biphasic effect and to study the relationship of the EEG effect to the moment of loss of consciousness. A biphasic effect, that is, an initial increase of the effect variable followed by a decrease at higher concentrations, during the transition from consciousness to unconsciousness was found in EEG amplitude (both frequency bands) and in SEF95 for all anaesthetics except midazolam. There was a concentration-related decrease in BIS for all anaesthetics. There was no consistent relationship between the time of occurrence of the peak EEG effect, or the value of the EEG variable and the moment of loss of consciousness. With rapidly changing drug concentrations during the induction of anaesthesia, none of these EEG effect variables could be correlated to the moment of loss of consciousness.

Br J Anaesth 2001; 86: 354–60


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