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Anesthesia with increasing doses of sufentanil and midlatency auditory evoked potentials in humans
D Schwender1, E Weninger, M Daunderer
1Institute for Anesthesiology, University of Munich, Germany.
Abstract:
Our interest focused on the question whether sufentanil differs from alfentanil, fentanyl, and morphine with regard on its effects on midlatency auditory evoked potentials (MLAEP). Therefore, we studied MLAEP during general anesthesia with increasing doses of sufentanil in 16 patients scheduled for elective major urologic surgery. Anesthesia was induced with sufentanil (1 microgram/kg every 7 min to a total dose of 3 micrograms/kg). In 8 of 16 patients, further incremental doses of sufentanil were given to a total dose of 5 micrograms/kg. Auditory evoked potentials were recorded before and 5 min after every sufentanil dose on vertex (positive) and mastoids on both sides (negative). Latencies of the peaks V, Na, Pa, Nb, and P1 (ms), and amplitudes Na/Pa, Pa/Nb, and Nb/P1 (microV) were measured. In the awake state, MLAEP had high peak-to-peak amplitudes and a periodic waveform. During general anesthesia the brainstem response V was stable to increasing doses of sufentanil. There was a marked statistically significant increase in latency and decrease in amplitude of Nb and P1 after 1-2 micrograms/kg sufentanil, which remained stable under further sufentanil application. In contrast, the early cortical potentials Na and Pa increased only slightly in latencies. This increase was statistically significant at 4 micrograms/kg for Na and at 3 and 4 micrograms/kg for Pa. For the amplitudes Na/Pa and Pa/Nb there was only a slight and statistically insignificant reduction. After the largest dose of sufentanil (3-5 micrograms/kg) Na and Pa showed a similar pattern as in awake patients. We conclude that sufentanil does not differ essentially from alfentanil, fentanyl, and morphine with regard on its effects on MLAEP.
Insights
Sufentanil
Area of Science:
- Anesthesiology
- Neuroscience
- Pharmacology
Background:
- Opioid analgesics like sufentanil are commonly used in anesthesia.
- Understanding their effects on brain activity, specifically auditory evoked potentials, is crucial for patient safety.
- Previous research has compared fentanyl, alfentanil, and morphine, but sufentanil's specific impact on midlatency auditory evoked potentials (MLAEP) requires clarification.
Purpose of the Study:
- To investigate the effects of increasing sufentanil doses on midlatency auditory evoked potentials (MLAEP).
- To compare sufentanil's impact on MLAEP with known effects of alfentanil, fentanyl, and morphine.
- To assess dose-dependent changes in MLAEP parameters during general anesthesia.
Main Methods:
- 16 patients undergoing major urologic surgery received incremental doses of sufentanil during general anesthesia.
- Midlatency auditory evoked potentials (MLAEP) were recorded in awake patients and after each sufentanil dose.
- Measurements included latencies and amplitudes of specific MLAEP peaks (V, Na, Pa, Nb, P1).
Main Results:
- The brainstem response (peak V) remained stable with increasing sufentanil doses.
- Significant increases in latency and decreases in amplitude were observed for later MLAEP components (Nb, P1) after low sufentanil doses (1-2 µg/kg).
- Early cortical potentials (Na, Pa) showed minimal latency increases, with amplitudes largely unaffected, returning to awake patterns at higher doses.
Conclusions:
- Sufentanil's effects on MLAEP are primarily on later components, with early cortical potentials showing relative stability.
- These findings suggest sufentanil does not significantly differ from other potent opioids like alfentanil, fentanyl, and morphine in its impact on MLAEP.
- Sufentanil can be safely administered within the studied dosage range without substantial disruption of MLAEP.