Skip to main content
Top
Published in: Journal of Anesthesia 5/2017

01-10-2017 | Original Article

Electroencephalographic effect of age-adjusted 1 MAC desflurane and sevoflurane in young, middle-aged, and elderly patients

Authors: Shinya Kanazawa, Yutaka Oda, Chika Maeda, Ryu Okutani

Published in: Journal of Anesthesia | Issue 5/2017

Login to get access

Abstract

Purpose

We examined the hypothesis that 1 minimum alveolar concentration (MAC) of desflurane and sevoflurane provides different depth of anesthesia.

Methods

One hundred and twenty young (20–30 years), middle-aged (31–65 years), and elderly (66–80 years) patients were randomly allocated to receive either desflurane or sevoflurane (n = 20, each group). General anesthesia was induced with propofol 2 mg/kg bolus and remifentanil 0.25 µg/kg/min, which was stopped after tracheal intubation. Maintenance of anesthesia was started with an end-tidal concentration of desflurane or sevoflurane at age-adjusted 1 MAC and maintained for 10 min, followed by 1-min assessment of bispectral index (BIS), 95% spectral edge frequency (SEF95), and amplitude of the electroencephalogram taken at 10-s intervals.

Results

BIS and SEF95 in patients receiving 1 MAC desflurane were significantly lower than those receiving 1 MAC sevoflurane including all age groups [35 (29, 39) vs. 41 (38, 49); 12.53 (10.99, 13.95) Hz vs. 14.42 (12.99, 17.17) Hz median (25, 75 percentile), respectively, P < 0.001 for both]. Both BIS and SEF95 in young patients were lower than in middle-aged and elderly patients receiving either desflurane or sevoflurane (P < 0.001 for both). There were no differences in amplitude between patients receiving desflurane and sevoflurane.

Conclusions

BIS as well as SEF95 were lower in patients receiving 1 MAC desflurane than those receiving 1 MAC sevoflurane, suggesting that desflurane provides higher depth of anesthesia than sevoflurane at 1 MAC.
Footnotes
Literature
1.
go back to reference Jakobsson J. Desflurane: a clinical update of a third-generation inhaled anaesthetic. Acta Anaesthesiol Scand. 2012;56:420–32.CrossRefPubMed Jakobsson J. Desflurane: a clinical update of a third-generation inhaled anaesthetic. Acta Anaesthesiol Scand. 2012;56:420–32.CrossRefPubMed
2.
go back to reference Weiskopf RB, Moore MA, Eger EI 2nd, Noorani M, McKay L, Chortkoff B, Hart PS, Damask M. Rapid increase in desflurane concentration is associated with greater transient cardiovascular stimulation than with rapid increase in isoflurane concentration in humans. Anesthesiology. 1994;80:1035–45.CrossRefPubMed Weiskopf RB, Moore MA, Eger EI 2nd, Noorani M, McKay L, Chortkoff B, Hart PS, Damask M. Rapid increase in desflurane concentration is associated with greater transient cardiovascular stimulation than with rapid increase in isoflurane concentration in humans. Anesthesiology. 1994;80:1035–45.CrossRefPubMed
3.
go back to reference Kim JK, Kim DK, Lee MJ. Relationship of bispectral index to minimum alveolar concentration during isoflurane, sevoflurane or desflurane anaesthesia. J Int Med Res. 2014;42:130–7.CrossRefPubMed Kim JK, Kim DK, Lee MJ. Relationship of bispectral index to minimum alveolar concentration during isoflurane, sevoflurane or desflurane anaesthesia. J Int Med Res. 2014;42:130–7.CrossRefPubMed
4.
go back to reference Fassoulaki A, Kaliontzi H, Petropoulos G, Tsaroucha A. The effect of desflurane and sevoflurane on cerebral oximetry under steady-state conditions. Anesth Analg. 2006;102:1830–5.CrossRefPubMed Fassoulaki A, Kaliontzi H, Petropoulos G, Tsaroucha A. The effect of desflurane and sevoflurane on cerebral oximetry under steady-state conditions. Anesth Analg. 2006;102:1830–5.CrossRefPubMed
5.
go back to reference Rampil IJ, Lockhart SH, Zwass MS, Peterson N, Yasuda N, Eger EI 2nd, Weiskopf RB, Damask MC. Clinical characteristics of desflurane in surgical patients: minimum alveolar concentration. Anesthesiology. 1991;74:429–33.CrossRefPubMed Rampil IJ, Lockhart SH, Zwass MS, Peterson N, Yasuda N, Eger EI 2nd, Weiskopf RB, Damask MC. Clinical characteristics of desflurane in surgical patients: minimum alveolar concentration. Anesthesiology. 1991;74:429–33.CrossRefPubMed
6.
go back to reference Gold MI, Abello D, Herrington C. Minimum alveolar concentration of desflurane in patients older than 65 yr. Anesthesiology. 1993;79:710–4.CrossRefPubMed Gold MI, Abello D, Herrington C. Minimum alveolar concentration of desflurane in patients older than 65 yr. Anesthesiology. 1993;79:710–4.CrossRefPubMed
7.
go back to reference Kanazawa S, Oda Y, Maeda C, Okutani R. Age-dependent decrease in desflurane concentration for maintaining bispectral index below 50. Acta Anaesthesiol Scand. 2016;60:177–82.CrossRefPubMed Kanazawa S, Oda Y, Maeda C, Okutani R. Age-dependent decrease in desflurane concentration for maintaining bispectral index below 50. Acta Anaesthesiol Scand. 2016;60:177–82.CrossRefPubMed
8.
go back to reference Oda Y, Tanaka K, Matsuura T, Hase I, Nishikawa K, Asada A. Nitrous oxide induces paradoxical electroencephalographic changes after tracheal intubation during isoflurane and sevoflurane anesthesia. Anesth Analg. 2006;102:1094–102.CrossRefPubMed Oda Y, Tanaka K, Matsuura T, Hase I, Nishikawa K, Asada A. Nitrous oxide induces paradoxical electroencephalographic changes after tracheal intubation during isoflurane and sevoflurane anesthesia. Anesth Analg. 2006;102:1094–102.CrossRefPubMed
9.
go back to reference Nickalls RW, Mapleson WW. Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane in man. Br J Anaesth. 2003;91:170–4.CrossRefPubMed Nickalls RW, Mapleson WW. Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane in man. Br J Anaesth. 2003;91:170–4.CrossRefPubMed
10.
go back to reference Conover WJ, Iman RL. Rank transformations as a bridge between parametric and nonparametric statistics. Am Stat. 1981;35:124–9. Conover WJ, Iman RL. Rank transformations as a bridge between parametric and nonparametric statistics. Am Stat. 1981;35:124–9.
11.
go back to reference Zorrilla-Vaca A, Healy RJ, Wu CL, Grant MC. Relation between bispectral index measurements of anesthetic depth and postoperative mortality: a meta-analysis of observational studies. Can J Anaesth. 2017;64:597–607.CrossRefPubMed Zorrilla-Vaca A, Healy RJ, Wu CL, Grant MC. Relation between bispectral index measurements of anesthetic depth and postoperative mortality: a meta-analysis of observational studies. Can J Anaesth. 2017;64:597–607.CrossRefPubMed
12.
go back to reference Umamaheswara Rao GS, Ali Z, Ramamoorthy M, Patil J. Equi-MAC concentrations of halothane and isoflurane do not produce similar bispectral index values. J Neurosurg Anesthesiol. 2007;19:93–6.CrossRefPubMed Umamaheswara Rao GS, Ali Z, Ramamoorthy M, Patil J. Equi-MAC concentrations of halothane and isoflurane do not produce similar bispectral index values. J Neurosurg Anesthesiol. 2007;19:93–6.CrossRefPubMed
13.
go back to reference Matsuura T, Oda Y, Tanaka K, Mori T, Nishikawa K, Asada A. Advance of age decreases the minimum alveolar concentrations of isoflurane and sevoflurane for maintaining bispectral index below 50. Br J Anaesth. 2009;102:331–5.CrossRefPubMed Matsuura T, Oda Y, Tanaka K, Mori T, Nishikawa K, Asada A. Advance of age decreases the minimum alveolar concentrations of isoflurane and sevoflurane for maintaining bispectral index below 50. Br J Anaesth. 2009;102:331–5.CrossRefPubMed
14.
go back to reference Matsuura T, Oda Y, Ikeshita K, Nishikawa K, Ito K, Asada A. Differential electroencephalographic response to tracheal intubation between young and elderly during isoflurane and sevoflurane nitrous oxide anaesthesia. Br J Anaesth. 2007;99:858–63.CrossRefPubMed Matsuura T, Oda Y, Ikeshita K, Nishikawa K, Ito K, Asada A. Differential electroencephalographic response to tracheal intubation between young and elderly during isoflurane and sevoflurane nitrous oxide anaesthesia. Br J Anaesth. 2007;99:858–63.CrossRefPubMed
15.
go back to reference Purdon PL, Pavone KJ, Akeju O, Smith AC, Sampson AL, Lee J, Zhou DW, Solt K, Brown EN. The ageing brain: age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia. Br J Anaesth. 2015;115(Suppl 1):i46–57.CrossRefPubMedPubMedCentral Purdon PL, Pavone KJ, Akeju O, Smith AC, Sampson AL, Lee J, Zhou DW, Solt K, Brown EN. The ageing brain: age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia. Br J Anaesth. 2015;115(Suppl 1):i46–57.CrossRefPubMedPubMedCentral
16.
17.
go back to reference Rice JK, Rorden C, Little JS, Parra LC. Subject position affects EEG magnitudes. Neuroimage. 2013;64:476–84.CrossRefPubMed Rice JK, Rorden C, Little JS, Parra LC. Subject position affects EEG magnitudes. Neuroimage. 2013;64:476–84.CrossRefPubMed
18.
go back to reference Hagihira S. Changes in the electroencephalogram during anaesthesia and their physiological basis. Br J Anaesth. 2015;115(Suppl 1):i27–31.CrossRefPubMed Hagihira S. Changes in the electroencephalogram during anaesthesia and their physiological basis. Br J Anaesth. 2015;115(Suppl 1):i27–31.CrossRefPubMed
19.
go back to reference Rampil IJ, Lockhart SH, Eger EI 2nd, Yasuda N, Weiskopf RB, Cahalan MK. The electroencephalographic effects of desflurane in humans. Anesthesiology. 1991;74:434–9.CrossRefPubMed Rampil IJ, Lockhart SH, Eger EI 2nd, Yasuda N, Weiskopf RB, Cahalan MK. The electroencephalographic effects of desflurane in humans. Anesthesiology. 1991;74:434–9.CrossRefPubMed
20.
go back to reference Pilge S, Jordan D, Kreuzer M, Kochs EF, Schneider G. Burst suppression-MAC and burst suppression-CP50 as measures of cerebral effects of anaesthetics. Br J Anaesth. 2014;112:1067–74.CrossRefPubMed Pilge S, Jordan D, Kreuzer M, Kochs EF, Schneider G. Burst suppression-MAC and burst suppression-CP50 as measures of cerebral effects of anaesthetics. Br J Anaesth. 2014;112:1067–74.CrossRefPubMed
21.
go back to reference Doenicke AW, Roizen MF, Rau J, O’Connor M, Kugler J, Klotz U, Babl J. Pharmacokinetics and pharmacodynamics of propofol in a new solvent. Anesth Analg. 1997;85:1399–403.CrossRefPubMed Doenicke AW, Roizen MF, Rau J, O’Connor M, Kugler J, Klotz U, Babl J. Pharmacokinetics and pharmacodynamics of propofol in a new solvent. Anesth Analg. 1997;85:1399–403.CrossRefPubMed
22.
go back to reference Kazama T, Ikeda K, Morita K, Kikura M, Doi M, Ikeda T, Kurita T, Nakajima Y. Comparison of the effect-site k(eO)s of propofol for blood pressure and EEG bispectral index in elderly and younger patients. Anesthesiology. 1999;90:1517–27.CrossRefPubMed Kazama T, Ikeda K, Morita K, Kikura M, Doi M, Ikeda T, Kurita T, Nakajima Y. Comparison of the effect-site k(eO)s of propofol for blood pressure and EEG bispectral index in elderly and younger patients. Anesthesiology. 1999;90:1517–27.CrossRefPubMed
23.
go back to reference Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical electroencephalography for anesthesiologists: part I: background and basic signatures. Anesthesiology. 2015;123:937–60.CrossRefPubMedPubMedCentral Purdon PL, Sampson A, Pavone KJ, Brown EN. Clinical electroencephalography for anesthesiologists: part I: background and basic signatures. Anesthesiology. 2015;123:937–60.CrossRefPubMedPubMedCentral
Metadata
Title
Electroencephalographic effect of age-adjusted 1 MAC desflurane and sevoflurane in young, middle-aged, and elderly patients
Authors
Shinya Kanazawa
Yutaka Oda
Chika Maeda
Ryu Okutani
Publication date
01-10-2017
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 5/2017
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-017-2391-6

Other articles of this Issue 5/2017

Journal of Anesthesia 5/2017 Go to the issue