Block-dependent sedation during epidural anaesthesia is associated with delayed brainstem conduction

British Journal of Anaesthesia
A G DoufasD I Sessler

Abstract

Neuraxial anaesthesia produces a sedative and anaesthetic-sparing effect. Recent evidence suggests that spinal cord anaesthesia modifies reticulo-thalamo-cortical arousal by decreasing afferent sensory transmission. We hypothesized that epidural anaesthesia produces sensory deafferentation-dependent sedation that is associated with impairment of brainstem transmission. We used brainstem auditory evoked potentials (BAEP) to evaluate reticular function in 11 volunteers. Epidural anaesthesia was induced with 2-chloroprocaine 2%. Haemodynamic and respiratory responses, sensory block level, sedation depth and BAEP were assessed throughout induction and resolution of epidural anaesthesia. Sedation was evaluated using verbal rating score (VRS), observer's assessment alertness/sedation (OAA/S) score, and bispectral index score (BIS). Prediction probability (PK) was used to associate sensory block with sedation, as well as BIS with other sedation measures. Spearman's rank order correlation was used to associate block level and sedation with the absolute and interpeak BAEP latencies. Sensory block level significantly predicted VRS (PK=0.747), OAA/S score (PK=0.748) and BIS. BIS predicted VRS and OAA/S score (PK=0.728). The latency of wav...Continue Reading

References

Dec 1, 1978·The Journal of Comparative Neurology·D L Oliver, W C Hall
Jan 1, 1979·Journal of Pharmaceutical Sciences·J E O'BrienM Finster
Sep 4, 1992·Brain Research·G Arankowsky-SandovalP E Gold
May 1, 1989·British Journal of Anaesthesia·D ChassardV Banssillon
Apr 1, 1989·Anesthesia and Analgesia·J R KambamB V Sastry
Jun 1, 1986·British Journal of Anaesthesia·P S SebelH Rogers
Jul 1, 1971·The Journal of Comparative Neurology·D M Schroeder, J A Jane
Nov 1, 1982·Anesthesia and Analgesia·M Y DuboisT E Macnamara
Aug 1, 1994·Anesthesia and Analgesia·Y InagakiI Yoshiya
Sep 1, 1995·Anesthesia and Analgesia·B Ben-DavidL Gaitini
Nov 1, 1994·Journal of Clinical Anesthesia·M TverskoyI Kissin
Jan 1, 1996·Anesthesiology·W D SmithN T Smith
Jan 1, 1996·Somatosensory & Motor Research·S A Northgrave, D D Rasmusson
Apr 22, 1999·British Journal of Anaesthesia·M GentiliF Bonnet
Dec 22, 1999·British Journal of Clinical Pharmacology·M A HotzW E Haefeli
Sep 2, 2000·Anesthesiology·J E PollockN Polissar
Aug 14, 2002·British Journal of Anaesthesia·J F Antognini, E Carstens
Aug 15, 1964·The Japanese Journal of Physiology·F MOTOKIZAWA, B FUJIMORI

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Citations

Nov 15, 2006·Journal of Clinical Monitoring and Computing·Leslie C Jameson, Tod B Sloan
Feb 8, 2011·Journal of Clinical Anesthesia·Marc E GentiliFrancis J Bonnet
Jan 16, 2009·Paediatric Anaesthesia·Nicola DismaAndrew J Davidson
Apr 2, 2015·Journal of Indian Association of Pediatric Surgeons·Abhishek BanerjeeMoushumi Khanra
Jul 1, 2010·Korean journal of anesthesiology·Joon-Sik KimJeong Rim Lee
Jan 1, 2008·Anesthesia and Analgesia·Anthony G DoufasDaniel I Sessler
Sep 13, 2021·Paediatric Anaesthesia·Emmett E WhitakerRobert K Williams
Dec 12, 2007·British Journal of Anaesthesia·D HöhenerA Borgeat

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