After written informed consent, we enrolled 31 subjects aged 45–65 yr, undergoing upper abdominal surgery using general anaesthesia from March to May 2012 at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. The study was approved by the local Institute's Ethical Committee (Huazhong University of Science and Technology) and registered with (ref: NCT01662622). In addition, haemodynamic stability and responses to incision in a state of isoelectric EEG were also analysed. Hence, this study aimed to determine the MAC of sevoflurane inducing isoelectric EEG (MACie) and burst suppression EEG (MACbs) in 50% of middle-aged adults. 12–16 Understanding the relation between concentrations of volatile anaesthetics and abnormal EEG states including burst suppression or isoelectric EEG might help practitioners avoid excessively deep anaesthesia in vulnerable patients, or achieve transient burst suppression or isoelectric EEG when desired. 11 Although still a controversial issue, low EEG-derived indices might be associated with adverse outcomes after cardiac and non-cardiac surgery. Previous studies have demonstrated that burst suppression or isoelectric EEG can be purposely induced by anaesthetic agents to protect the brain during neurosurgery 10 or cardiosurgery. 9 They are frequently observed in deep general anaesthesia, pathological conditions including hypothermia, hypoxic–ischaemic trauma, coma, and early infantile encephalopathy. 8ĮEG burst suppression and isoelectric (or persistently suppressed) EEG, typically associated with states of profound brain inactivation, do not appear in normal sleep. However, the relation between concentration of sevoflurane and different EEG states is relatively unstudied. Its effects on motor response (MAC), 3 adrenergic reflexes (MACBAR), 4, 5 reflex pupillary dilatation (MACpup) 6 to nociceptive stimulation, and eye opening to verbal command (MACawake) 7 in 50% of subjects have been widely investigated. 1, 2 Sevoflurane is a commonly used inhalation anaesthesia agent today.
Minimal alveolar concentration (MAC) was introduced to compare the potencies of inhalation anaesthetic agents.
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The minimal alveolar concentration (MAC) of sevoflurane for isoelectric EEG was 3.5 vol%, which is about 2.1 times the MAC for skin incision.
The potency of sevoflurane in producing an isoelectric EEG was determined in adult human subjects before surgical incision. Induction of an isoelectric EEG by anaesthetics has been implicated in neuroprotection, and might be clinically useful or detrimental in specific situations.
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