General Anesthesia Clinical Trial
Official title:
Minimum Alveolar Concentration of Sevoflurane With 60% Nitrous Oxide Inducing Isoelectric EEG in Mid-aged Adults
In order to investigate the effect of a combination effect of sevoflurane and nitrous oxide on cerebral electrical activity, the investigators determined the MAC of sevoflurane combined with nitrous oxide inducing isoelectric electroencephalogram (EEG) in 50% of the subjects (MACie) in middle aged subjects.
Anaesthesia was induced by sevoflurane in oxygen. Cisatracurium 0.15 mg kg-1 was
administered after loss of the lash reflex, then ventilated manually until the amplitude of
T1 decreased to 0. Intubation was performed and switched to mechanical ventilation with a
fresh gas flow of 2 L min-1. Anesthesia was maintained by sevoflurane or sevoflurane+60%
nitrous oxide respectively. The surgical incision was performed at least 30 min after
tracheal intubation, provided that the predetermined end-tidal sevoflurane concentration had
been constant for at least 30 min and that the difference between inspired and end-tidal
concentrations was less than 10%.
Brain electrical activity was measured using Narcotrend Monitor and S/5 Compact Anaesthesia
Monitor, which displayed unprocessed EEG and burst suppression ratio, respectively. The
design of the experiment is referred to the "Dixon up-and-down" method. To avid anaesthesia
awareness, the first subject was designed to receive end-tidal sevoflurane concentration of
2.5 %. The presence or absence of isoelectric EEG (Entropy Module) of the preceding patient
determined the end-tidal concentration of sevoflurane given to the next patient (with an
increment size of 0.2%). The isoelectric EEG was considered as significant when the
isoelectric state last for more than 1 min. The maximal burst suppression rate was recorded
if isoelectric EEG was not reached.
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Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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