Use of EEG spectral edge as index of equipotency in a comparison of propofol and isoflurane for maintenance of general anaesthesia

G. M. Gurman, S. Fajer, A. Porat, M. Schily, A. Pearlman

    Research output: Contribution to journalArticlepeer-review

    13 Scopus citations

    Abstract

    Propofol and isoflurane were compared for haemodynamic stability and recovery time as main anaesthetic agents for maintenance in a total of 43 ASA I and II patients in uncomplicated operations lasting at least 30 min. The premedication (oral diazepam), induction (thiopentone-fentanyl-suxamethonium) and maintenance protocol (N2O-O2 2:1 litre min-1, fentanyl and vecuronium in incremental doses) were identical for all patients. In one group of 20 patients, propofol was used in continuous intravenous (i.v.) infusion (starting dose 3 mg kg-1 h-1), while in the second group of 23 patients, isoflurane was administered in a starting concentration of 1%. To improve the equipotency of the two agents in all cases the dose of the main anaesthetic was titrated to keep the EEG 90% spectral edge frequency (SEF - recorded by processed EEG monitor) between 8 and 12 Hz. Mean blood pressure (BP) and heart rate (HR) deviations of ± 20% from the baseline were recorded. The incidence of mean blood pressure deviations/case in the propofol group was less than half of those occurring in the isoflurane group (0.45 vs. 0.96 P = 0.04). The mean duration of blood pressure deviation from baseline value was 5.5 min in the propofol group vs. 16.8 min in the isoflurane group (P = 0.01). The recovery intervals were significantly shorter in the propofol group (P < 0.05). We conclude that continuous i.v. administration of propofol for maintenance of general anaesthesia produces a significantly more stable blood pressure, as well as a quicker recovery, in comparison with those encountered with normally acceptable concentrations of isoflurane. EEG spectral edge frequency titration in the range of 8-12 Hz is a useful method for equipotent comparison of propofol and isoflurane and also appears to prevent awareness with these agents.

    Original languageEnglish
    Pages (from-to)443-448
    Number of pages6
    JournalEuropean Journal of Anaesthesiology
    Volume11
    Issue number6
    StatePublished - 1 Jan 1994

    Keywords

    • Anaesthetic
    • Anaesthetics intravenous
    • Anaesthetics volatile
    • Awareness
    • Blood pressure
    • Brain
    • Complications
    • Drug effects
    • EEG
    • Isoflurane
    • Potency
    • Propofol
    • Recovery
    • Spectral edge frequency

    ASJC Scopus subject areas

    • Anesthesiology and Pain Medicine

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