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NEUROSURGICAL ANESTHESIA

The Effects of Isoflurane and Desflurane Titrated to a Bispectral Index of 60 on the Cortical Somatosensory Evoked Potential During Pediatric Scoliosis Surgery

James E. Fletcher, MB BS, MRCP, FRCA^*, Albert R. Hinn, MD^*, Christopher M. Heard, MB ChB, Linda S. Georges, MD^*, Eugene B. Freid, MD^*, Ann Keifer, MD^*, Sandra D. Brooks, R.EEG/EPT, CNIM^*, Ann G. Bailey, MD^*, and Robert D. Valley, MD^*

*Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and Department of Anesthesiology, Children’s Hospital Buffalo, Buffalo, New York

Address correspondence to James E. Fletcher, MB BS, MRCP, FRCA, Department of Anesthesiology, University of North Carolina at Chapel Hill, CB #7010, Chapel Hill, NC 27599-7010. Address e-mail to jfletcher{at}aims.unc.edu. Reprints will not be available from the authors.

In this study, we compared the effect of isoflurane and desflurane on the posterior tibial somatosensory evoked potential recorded by scalp electrodes during correction of idiopathic scoliosis in pediatric patients. Depth of sedation was controlled by maintaining bispectral index (BIS) at 60 throughout the study. Comparison of patients breathing desflurane and isoflurane showed an evoked cortical amplitude (N37-P45) of 0.53 ± 0.3 µV versus 1.3 ± 0.8 µV (P = 0.014), respectively. In addition to this comparison, a crossover design was included whereby the desflurane or isoflurane received in the first part of the study was changed to the other anesthetic. Substituting one anesthetic for another confirmed our initial finding that the cortical evoked amplitude is greater with isoflurane than with desflurane. No differential effect was found between desflurane and isoflurane on the evoked subcortical (N31-P34) amplitude or the P37 latency.