Epileptiform Electroencephalogram during Mask Induction of Anesthesia with Sevoflurane

• Arvi Yli-Hankala

  Associate Professor of Anesthesia, Department of Obstetrics and Gynecology, Helsinki University Central Hospital.

• Anne Vakkuri

  Staff Anesthesiologist, Department of Obstetrics and Gynecology, Helsinki University Central Hospital.

• Mika Särkelä

  Research Scientist, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.

• Leena Lindgren

  Associate Professor of Anesthesia, IV Department of Surgery, Helsinki University Central Hospital.

• Kari Korttila

  Professor of Anesthesia and Critical Care, Department of Obstetrics and Gynecology, Helsinki University Central Hospital.

• Ville Jäntti

  Associate Professor of Clinical Neurophysiology, Department of Clinical Neurophysiology, Oulu University Hospital, Oulu, Finland.

抄録

Sevoflurane is suggested as a suitable anesthetic agent for mask induction in adults. The authors recently found that hyperventilation during sevoflurane-nitrous oxide-oxygen mask induction is associated with cardiovascular hyperdynamic response. We tested the hypothesis that the hyperdynamic response can be explained by electroencephalography (EEG) findings. Thirty women were randomly allocated to receive sevoflurane-nitrous oxygen-oxygen mask induction using a single-breath method, followed by either spontaneous breathing (n = 15) or controlled hyperventilation (n = 15) for 6 min. EEG was recorded. Blood pressure and heart rate were recorded at 1-min intervals. Epileptiform EEG activity (spikes or polyspikes) was seen in all patients with controlled hyperventilation, and in seven patients with spontaneous breathing (P < 0.01). Jerking movements were seen in three patients with controlled hyperventilation. In the controlled hyperventilation group, heart rate increased 54% from baseline at 4 min after induction (P < 0.001). Mean arterial pressure increased 17% (P < 0.05), peaking at 3 min. In the spontaneous breathing group, heart rate showed no change, and mean arterial pressure decreased by 14% (P < 0.01) at 6 min. Heart rate and mean arterial pressure differed significantly between the groups from 2 min after beginning of the induction to the end of the trial. An increase in heart rate of more than 30% from baseline always was associated with epileptiform EEG activity. Sevoflurane mask induction elicits epileptiform EEG patterns. These are associated with an increase in heart rate in patients with controlled hyperventilation and also during spontaneous breathing of sevoflurane.

収録刊行物

• Anesthesiology

  Anesthesiology 91 (6), 1596-1596, 1999-12-01

  Ovid Technologies (Wolters Kluwer Health)

キーワード

• Anesthesiology and Pain Medicine

詳細情報

• CRID: 1363388844092475904
• NII論文ID: 30009125920
• DOI: 10.1097/00000542-199912000-00009
• ISSN: 00033022
• Web Site: http://pubs.asahq.org/anesthesiology/article-pdf/91/6/1596/399288/0000542-199912000-00009.pdf
• Web Site: http://journals.lww.com/00000542-199912000-00009
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