Evaluation of the actions of general anaesthetics in the human brain. 1992

J Jessop, and J G Jones
Department of Anaesthetics, Doncaster Royal Infirmary, England.

1. General anaesthesia is a state of analgesia and impaired cognitive function that results from the depressant effects of anaesthetics. 2. Graded increases in anaesthetic concentration cause a progressive impairment of cognitive function, the extremes of which are commonly described as "light" and "deep" anaesthesia. 3. Surgical stimulation produces activation in the EEG and may arouse a patient from a deeper to a lighter state of cognitive function. 4. It may be very difficult, particularly in patients with neuromuscular blockade, to identify a change in state which results in conscious awareness. 5. A range of methods has been used for evaluating depth of anaesthesia. 6. The evidence reviewed in this paper suggests that the median frequency in the EEG and the auditory evoked potential appear to be the best techniques for monitoring the graded effects of anaesthetics on the brain. 7. The median frequency, which is 10 Hz in conscious subjects, should be kept below 5 Hz during anaesthesia to ensure that there is no response to verbal command. 8. The auditory evoked potential measures the resulting effects of anaesthetic depression and surgical stimulation which is "depth of anaesthesia". 9. However it is not yet certain whether a particular feature e.g. Nb latency, or a collection of features between 20 and 80 msec gives the most reliable index of conscious awareness.

UI MeSH Term Description Entries
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias
D000777 Anesthetics Agents capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general ANESTHESIA, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. Anesthetic,Anesthetic Agents,Anesthetic Drugs,Anesthetic Effect,Anesthetic Effects,Agents, Anesthetic,Drugs, Anesthetic,Effect, Anesthetic,Effects, Anesthetic

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