Comparison of the two different auditory evoked potentials index monitors in propofol-fentanyl-nitrous oxide anesthesia. 2009

Tomoki Nishiyama
Department of Anesthesiology and Critical Care, Kamagaya General Hospital, Kamagaya, Chiba, Japan. nishit-tky@umin.ac.jp

OBJECTIVE To determine the difference in performance of two different auditory evoked potentials (AEP) monitors, the A-Line AEP (AAI) and the aepEX, and their indices, during general anesthesia. METHODS Prospective study. METHODS Operating room at a private hospital. METHODS 40 ASA physical status I and II women, aged 30 to 70 years, scheduled for partial mastectomy. METHODS Anesthesia was induced with propofol and fentanyl, and a Laryngeal Mask Airway (LMA) was inserted. Anesthesia was maintained with propofol, fentanyl, and nitrous oxide. RESULTS The AAI or the aepEX was continuously monitored and their performance was compared at the start of monitoring, at LMA insertion, after disturbance by electric cautery, and during anesthesia. Eighteen of 20 patients had low enough impedance to extract good electroencephalogram signals at the first electrode application with the A-Line AEP, and 14 of 20 patients, with the aepEX. The time to return to good signals after signal disturbance by electric cautery was 14 +/- 3 seconds (SD) with the AAI and 19 +/- 4 seconds (SD) with the aepEX (P = 0.035). Both AAI and aepEX decreased after anesthesia induction, with significantly lower values seen in AAI than the aepEX. CONCLUSIONS The A-Line AEP (AAI) is better detects the response to painful stimuli and during recovering from noise of electric cautery than the aepEX. The aepEX shows higher values than the AAI during propofol-fentanyl-nitrous oxide anesthesia.

UI MeSH Term Description Entries
D008408 Mastectomy Surgical procedure to remove one or both breasts. Mammectomy,Mammectomies,Mastectomies
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009609 Nitrous Oxide Nitrogen oxide (N2O). A colorless, odorless gas that is used as an anesthetic and analgesic. High concentrations cause a narcotic effect and may replace oxygen, causing death by asphyxia. It is also used as a food aerosol in the preparation of whipping cream. Laughing Gas,Nitrogen Protoxide,Gas, Laughing,Oxide, Nitrous
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002425 Cautery The application of a caustic substance, a hot instrument, an electric current, or other agent to control bleeding while removing or destroying tissue. Cauterization,Cauterizations
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D005072 Evoked Potentials, Auditory The electric response evoked in the CEREBRAL CORTEX by ACOUSTIC STIMULATION or stimulation of the AUDITORY PATHWAYS. Auditory Evoked Potentials,Auditory Evoked Response,Auditory Evoked Potential,Auditory Evoked Responses,Evoked Potential, Auditory,Evoked Response, Auditory,Evoked Responses, Auditory,Potentials, Auditory Evoked
D005260 Female Females
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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