Fentanyl and Morphine Effects on Intraoperative Somatosensory Cortical Evoked Potentials

Pathak, Kalindi S.; Brown, R. H.; Cascorbi, Helmut F.; Nash, Clyde L.

doi:10.1097/00000542-198209001-00319

Cited by 16 publications

(16 citation statements)

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“…The interaction between the drugs used in this study on SSEP is not known, as the influence of concomitant use of several drugs for premedication and anaesthesia has not always been considered in the literature [4]. However, diazepam 10 mg probably had no effect on SSEP as Loughnan and colleagues [5] demonstrated that the i.v.…”

Section: Commentmentioning

confidence: 90%

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Median Nerve Evoked Potentials During Propofol Anaesthesia

Scheepstra¹,

Lange²,

Booij³

et al. 1989

British Journal of Anaesthesia

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Section: Commentmentioning

confidence: 90%

“…High doses of fentanyl undoubtedly increase latencies and decrease cortical amplitudes, but it has been demonstrated that the N20 latency increases with low doses of fentanyl [4]. Thus an effect of fentanyl cannot be excluded.…”

Section: Commentmentioning

confidence: 99%

Median Nerve Evoked Potentials During Propofol Anaesthesia

Scheepstra¹,

Lange²,

Booij³

et al. 1989

British Journal of Anaesthesia

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“…Despite differences in stimulus and recording parameters, subject population and narcotic dose, our results conform to the general trend observed by these previous investigators. 3,4 It is recognized that the number of palient~ studied in the present report is small and that the standard deviations of our data are substantial, However, the study was designed sueh thai each patient served as his or her own control. The magnitude of the observed standard deviations at control, t = 20 and t = 45 is therefore primarily a result of variability between patients, not between groups at different time~ of observation.…”

Section: Discussionmentioning

confidence: 88%

The effect of high-dose fentanyl on human median nerve somatosensory-evoked responses

et al. 1987

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Median nerve somatoaensory evoked responses (MnSSERs) were recorded in nine neurologically normal adult cardiac patients before and during the administration of high-dose fentanyl. MnSSERs were recorded prior to induction and at r = 20rain and t = 45 rain postinduction. Fentanyl was administered as a slow bolus , followed by a continuous infusion at [10][11][12][13][14][15][16][17][18][19][20] From the Uniformed Services University of The Health Sciences, Naval Hospital, Bethesda, MD (AS) and the University of California, San Diego.The opinions expressed herein are those of the authnrs and me not to be construed as reflecting the views of the U.S, Navy Department, the U.S Naval Service at large or of the U.S. Department of Defense.Address correspot~lence to: Dr. John C. Drummond, Neuroanesthesia Research, M-029, La Jolla, CA 92093.High-dose fentanyl anaesthesia is frequently employed for patients undergoing major nenrologic and cardiovascular surgery. Sensory evoked response (SER) monitoring may be relevant during certain of these procedures. Accurate interpretation of SER changes requires a knowledge of the effect of the anaesthetic in use on the evoked response waveform, since anaesthetics can produce SER changes mimicking an injury pattern. We sought to define the effect of fentanyl in doses exceeding 30 p,g.kg-t on the human median nerve somatosensory evoked response (MnSSER). MethodsThis study was approved by the Committee on Investigations Involving Human Subjects of the University of California, San Diego. Nine neurologically normal adult subjects (mean age 66 -+ 11 years) scheduled for valve replacement or coronary artery bypass grafting were studied. Each gave informed consent. At the time of the study, the majority of the patients were taking one or more chronic medications for the treatment of their cardiovascular disease or other medico2 conditions, none of which are known to affect SERs.The night before surgery, patients received either Iorazepam 2 mg or flurazepam 30 mg PO. On the day of surgery, premedieation consisted of diazepam 0.1-0.2 mg PO and morphine 0.08-0.15rag IM (three patients received, in addition, scopolamine 0.2-04 mg IM) 30-60 rain prior to transfer to the operating suite. Radial, pulmonary artery, and intravenous catheters were inserted under local anaesthesia. The latter was placed in the forearm contralateral to the extremity to be stimulated for MnSSER recording.MnSSERs were recorded using a Pathfinder I1 Electrodiagnostic Monitor (Nicolet Biomedical, Madison WI 53711). The stimulation sites over the median nerve at the wrist were identified with a block electrode stimulator (intereleetrode distance = 3 era). Adhesive electrodes were applied and the stimuli, which consisted of 200 constant current impulses of 100 ~xsec duration, were CAN J ANAESTH 1987 / 24:1 / ppJ5-40

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“…Although the administration of propofol causes dose-dependent increases in amplitude, it does not have a large effect on latency. Opioids, in general, produce dosedependent changes in SSEPs but clinical doses can be used in patients requiring SSEPs intraoperatively without impairing the ability to monitor the neurologic function adequately [13,14]. A neuromuscular blockade has been demonstrated to have large effects on MEPs but not on SSEPs.…”

Section: Discussionmentioning

confidence: 99%