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TECHNOLOGY, COMPUTING, AND SIMULATION

Direct Current Auditory Evoked Potentials During Wakefulness, Anesthesia, and Emergence from Anesthesia

Robert D. Fitzgerald, MD^*, Claus Lamm, MSc, Wolfgang Oczenski, MD, Thomas Stimpfl, PhD^§, Walter Vycudilik, PhD^§, and Herbert Bauer, PhD

*Ludwig Boltzmann Institute for Economics of Medicine in Anesthesia and Intensive Care and the Brain Research Laboratory, Department of Psychology, University of Vienna; the Department of Anesthesia and Intensive Care Medicine, City of Vienna Hospital Lainz; and §the Institute of Forensic Medicine, University of Vienna, Vienna, Austria

Address correspondence and reprint requests to Claus Lamm, MSc, Brain Research Laboratory, Department of Psychology, Liebiggasse 5, A-1010 Vienna. Address e-mail to claus.lamm{at}univie.ac.at

Direct current auditory evoked potentials (DC-AEPs) are a sensitive indicator of depth of anesthesia in animals. However, they have never been investigated in humans. To assess the potential usefulness of DC-AEPs as an indicator of anesthesia in humans, we performed an explorative study in which DC-AEPs were recorded during propofol and methohexital anesthesia in humans. DC-AEPs were recorded via 22 scalp electrodes in 19 volunteers randomly assigned to receive either propofol or methohexital. DC-AEPs were evoked by binaurally presented 2-s, 60-dB, 800-Hz tones; measurements were taken during awake baseline, anesthesia, and emergence. Statistical analysis included analysis of variance and discriminant analysis of data acquired during these three conditions. About 500 ms after stimulus presentation, DC-AEPs could be observed. These potentials were present only during baseline and emergence—not during anesthesia. Statistically significant differences were found between baseline and anesthesia and between anesthesia and emergence. In conclusion, similar effects, as reported in animal studies of anesthetics on the DC-AEPs, could be observed in anesthetized humans. These results demonstrate that DC-AEPs are potentially useful in the assessment of cortical function during anesthesia and might qualify the method for monitoring anesthesia in humans.

Implications: This study demonstrates the potential of direct current auditory evoked potentials for monitoring depth of anesthesia in humans.