open access

Vol 51, No 1 (2019)
Original and clinical articles
Published online: 2019-02-06
Submitted: 2017-12-23
Accepted: 2019-01-20
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Epileptiform EEG patterns during different techniques of induction of general anaesthesia with sevoflurane and propofol: a randomised trial

Michał Jan Stasiowski, Radosław Marciniak, Anna Duława, Lech Krawczyk, Przemysław Jałowiecki
DOI: 10.5603/AIT.a2019.0003
·
Pubmed: 30723886
·
Anaesthesiol Intensive Ther 2019;51(1):21-34.

open access

Vol 51, No 1 (2019)
Original and clinical articles
Published online: 2019-02-06
Submitted: 2017-12-23
Accepted: 2019-01-20

Abstract

Background: The aim of the study was to assess the influence of volatile induction of general anaesthesia with sevoflurane using two different techniques and intravenous anaesthesia with propofol on the possible presence of epileptiform electroencephalograph patterns during the induction of general anaesthesia. Methods: Sixty patients (age 18-70 years) were recruited. Exclusion criteria included history of epilepsy, neurological or neurosurgical diseases, pre-existing EPs in initial EEG recordings, medication interfering with EEG patterns. Patients were randomly allocated into three different groups: A (sevoflurane, increasing concentrations technique); B (sevoflurane, vital capacity technique); C (intravenous propofol). The clinical and instrumental monitoring included arterial blood pressure, heart rate, standard electrocardiography II, arterial oxygen saturation, facial electromyography, fraction of inspired sevoflurane, fraction of expired sevoflurane, minimal alveolar concentration of sevoflurane, and BIS. Results: Neurophysiological analysis of EEGs showed different EPs: polyspikes (PS), rhythmic polyspikes (PSR), and periodic epileptiform discharges (PED). EPs (p < 0.05) were observed in Group A (56%) and Group B (37%), but not in Group C. One patient in group B presented with clinical seizures. No significant differences in the vital parameters and anaesthesia parameters between groups was observed, regardless of the presence of EPs, which were associated with both low and more likely high (falsely indicating awakening from anaesthesia) BIS scores. Conclusion: Our study shows that the BIS score variations do not detect epileptiform activity, which was associated with both low and high scores. The sevoflurane concentration reached either sedative or toxic concentrations.

Abstract

Background: The aim of the study was to assess the influence of volatile induction of general anaesthesia with sevoflurane using two different techniques and intravenous anaesthesia with propofol on the possible presence of epileptiform electroencephalograph patterns during the induction of general anaesthesia. Methods: Sixty patients (age 18-70 years) were recruited. Exclusion criteria included history of epilepsy, neurological or neurosurgical diseases, pre-existing EPs in initial EEG recordings, medication interfering with EEG patterns. Patients were randomly allocated into three different groups: A (sevoflurane, increasing concentrations technique); B (sevoflurane, vital capacity technique); C (intravenous propofol). The clinical and instrumental monitoring included arterial blood pressure, heart rate, standard electrocardiography II, arterial oxygen saturation, facial electromyography, fraction of inspired sevoflurane, fraction of expired sevoflurane, minimal alveolar concentration of sevoflurane, and BIS. Results: Neurophysiological analysis of EEGs showed different EPs: polyspikes (PS), rhythmic polyspikes (PSR), and periodic epileptiform discharges (PED). EPs (p < 0.05) were observed in Group A (56%) and Group B (37%), but not in Group C. One patient in group B presented with clinical seizures. No significant differences in the vital parameters and anaesthesia parameters between groups was observed, regardless of the presence of EPs, which were associated with both low and more likely high (falsely indicating awakening from anaesthesia) BIS scores. Conclusion: Our study shows that the BIS score variations do not detect epileptiform activity, which was associated with both low and high scores. The sevoflurane concentration reached either sedative or toxic concentrations.
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Keywords

anaesthetics, volatile, sevoflurane; anaesthetics, intravenous, propofol; anaesthesia, monitoring, bispectral index; electroencephalogram, epileptiform patterns

About this article
Title

Epileptiform EEG patterns during different techniques of induction of general anaesthesia with sevoflurane and propofol: a randomised trial

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 51, No 1 (2019)

Pages

21-34

Published online

2019-02-06

DOI

10.5603/AIT.a2019.0003

Pubmed

30723886

Bibliographic record

Anaesthesiol Intensive Ther 2019;51(1):21-34.

Keywords

anaesthetics
volatile
sevoflurane
anaesthetics
intravenous
propofol
anaesthesia
monitoring
bispectral index
electroencephalogram
epileptiform patterns

Authors

Michał Jan Stasiowski
Radosław Marciniak
Anna Duława
Lech Krawczyk
Przemysław Jałowiecki

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