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Anesth Analg 1988; 67:435-441
© 1988 International Anesthesia Research Society
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Effects of Etomidate, Midazolam, and Thiopental on Median Nerve Somatosensory Evoked Potentials and the Additive Effects of Fentanyl and Nitrous Oxide

Antoun Koht, MD, Wolfram Schütz, MD, Gerhard Schmidt, Johannes Schramm, MD, and Eiju Watanabe, MD

The Department of Anesthesia, Northwestern University, Chicago, Illinois, and the Departments of Anesthesia and Neurosurgery, University of Erlangen-Nürnberg, West Germany.

Abstract

In 30 patients undergoing spinal disc operations, the effects of bolus injections followed by intravenous infusions of thiopental, etomidate, and midazolam on median nerve Somatosensory-evoked potentials (SSEPs) were studied. Possible additive effects of fentanyl and nitrous oxide were also evaluated. Serial SSEP measurements were made before and for 25 minutes after the start of anesthesia. After induction with one of the three intravenous agents, fentanyl (10 µg/kg) was administered and SSEPs were again measured 1 and 5 minutes after administration. Sixty-five% nitrous oxide in 35% oxygen was administered after tracheal intubation and was followed by final SSEP measurements. The three intravenous agents affected SSEP signals differently. Etomidate increased both amplitude and latency. Thiopental decreased amplitude and increased latency. Midazolam had no effect on amplitude but increased latency. The addition of fentanyl and nitrous oxide had different effects in response to the three intravenous induction agents. This study emphasizes the differences in SSEP responses not only to different intravenous induction agents but also to the addition of fentanyl and nitrous oxide.

Key Words: ANESTHETICS, INTRAVENOUS—etomidate, thiopental, midazolam, fentanyl. • BRAIN—Somatosensory evoked potentials. • HYPNOTICS, BENZODIAZEPINES—midazolam. • ANALGESICS—fentanyl. • ANESTHETICS, GASES—nitrous oxide.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.