Monitoring of anesthetic depth with q-EEG (quantitative EEG) in TIVA (total intravenous anesthesia) and VIMA (volatile induction/maintenance anesthesia)

완전정맥마취와 휘발성유도/유지마취에서 정량적 뇌파를 이용한 마취심도의 감시

  • Lee, Soo-Han (College of Veterinary Medicine, Konkuk University) ;
  • Noh, Gyu-Jeong (Department of Anesthesiology and Pain Medicine, and Clinical Pharmacology and Therapeutics, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chung, Byung-Hyun (College of Veterinary Medicine, Konkuk University)
  • 이수한 (건국대학교 수의과대학) ;
  • 노규정 (울산의대 서울아산병원 마취통증의학교실 및 임상약리학교실) ;
  • 정병현 (건국대학교 수의과대학)
  • Accepted : 2006.01.03
  • Published : 2006.03.29


To evaluate method for monitoring anesthetic depth with quantitative electroencephalography (q-EEG), we recorded processed EEG (raw EEG) and pain score till 100 minutes in beagle dogs anesthetized for 60 minutes with propofol (n = 5, PRO group), isoflurane (n = 5, ISO group) and propofol-ketaminefentanyl (n = 5, PFK group). Raw EEG was converted into 95% spectral edge frequency (SEF) by fast Fourier transformation (FFT) method. We investigated anesthetic depth by comparing relationship (Pearson's correlation) between q-EEG (95% SEF) and pain score. Pearson's correlation coefficients are +0.2372 (p = 0.0494, PRO group), +0.79506 (p < 0.001, ISO group) and +0.49903 (p = 0.0039, PFK group).



  1. Baraka A, Aouad M. Is propofol anticonvulsant or proconvulsant? Can J Anaesth 1997, 44, 1027
  2. Cockshott ID, Douglas EJ, Plummer GF, Simons PJ. The pharmacokinetics of propofol in laboratory animals. Xenobiotica 1992, 22, 369-375
  3. Daube JR, Harper CM, Litchy WJ, Sharbrough FW. Intraoperative monitoring. In: Daly DD, Pedley TA (eds.). Current Practice of Clinical Electroencephalography. pp. 739-779, Raven Press, New York, 1990
  4. De Jonghe B, Cook D, Appere-De-Vecchi C, Guyatt G, Meade M, Outin H. Using and understanding sedation scoring systems: a systematic review. Intensive Care Med 2000, 26, 275-285
  5. Greene SA, Benson GJ, Tranquilli WJ, Grimm KA. Relationship of canine bispectral index to multiples of sevoflurane minimal alveolar concentration, using patch or subdermal electrodes. Comp Med 2002, 52, 424-428
  6. Hirota K, Kubota T, Ishihara H, Matsuki A. The effects of nitrous oxide and ketamine on the bispectral index and 95% spectral edge frequency during propofol-fentanyl anaesthesia. Eur J Anaesthesiol 1999, 16, 779-783
  7. Itamoto K, Taura Y, Wada N, Takuma T, Une S, Nakaichi M, Hikasa Y. Quantitative electroencephalography of medetomidine, medetomidine-midazolam and medetomidine-midazolam-butorphanol in dogs. J Vet Med A physiol Pathol Clin Med 2002, 49, 169-172
  8. Levy WJ. Intraoperative EEG patterns: implications for EEG monitoring. Anesthesiology 1984, 60, 430-434
  9. Mi WD, Sakai T, Singh H, Kudo T, Kudo M, Matsuki A. Hypnotic endpoints vs. the bispectral index, 95% spectral edge frequency and median frequency during propofol infusion with or without fentanyl. Eur J Anaesthesiol 1999, 16, 47-52
  10. Otto KA, Gerich T. Comparison of simultaneous changes in electroencephalographic and haemodynamic variables in sheep anaesthetised with halothane. Vet Rec 2001, 149, 80-84
  11. Seifert HA, Blouin RT, Conard PF, Gross JB. Sedative doses of propofol increase beta activity of the processed electroencephalogram. Anesth Analg 1993, 76, 976-978
  12. Clark DL, Rosner BS. Neurophysiologic effects of general anesthetics. I. The electroencephalogram and sensory evoked responses in human. Anesthesiology 1973, 38, 564-582
  13. Weaver BM, Raptopoulos D. Induction of anaesthesia in dogs and cats with propofol. Vet Rec 1990, 126, 617-620
  14. Thurmon JC, Tranquilli WJ, Benson GJ. Veterinary Anesthesia. 3rd ed. pp. 16-19, Lippincott Williams & Wilkins, Baltimore, 1996
  15. Reid J, Nolan AM. Pharmacokinetics of propofol in dogs premedicated with acepromazine and maintained with halothane and nitrous oxide. J Vet Pharmacol Ther 1993, 16, 501-505
  16. Redding RW. Canine Electroencephalography. In: Hoerlein BF (ed.). Canine Neurology. 2nd ed. pp. 113-115, Saunders, Philadelphia, 1971
  17. 이수한, 배춘식, 노규정, 배균섭, 김진영, 정병현. 간헐적 일시 정맥주사 마취에서 정량적 뇌파분석을 이용한 마취 심도의 평가. 대한수의학회지 2005, 45, 131-137
  18. Schwender D, Daunderer M, Mulzer S, Klasing S, Finsterer U, Peter K. Spectral edge frequency of the electroencephalogram to monitor 'depth' of anaesthesia with isoflurane or propofol. Br J Anaesth 1996, 77, 179-184
  19. Duffy FH, Hughes JR, Miranda F, Bernad P, Cook P. Status of quantitative EEG (QEEG) in clinical practice, 1994. Clin Electroencephalogr 1994, 25, VI-XXII
  20. Bergamasco L, Accatino A, Priano L, Neiger-Aeschbacher G, Cizinauskas S, Jaggy A. Quantitative electroencephalographic findings in beagles anaesthetized with propofol. Vet J 2003, 166, 58-66
  21. Drummond JC, Brann CA, Perkins DE, Wolfe DE. A comparison of median frequency, spectral edge frequency, a frequency band power ratio, total power, and dominance shift in the determination of depth of anaesthesia. Acta Anaesthesiol Scand 1991, 35, 693-699
  22. Greene SA, Tranquilli WJ, Benson GJ, Grimm KA. Effect of medetomidine administration on bispectral index measurements in dogs during anesthesia with isoflurane. Am J Vet Res 2003, 64, 316-320
  23. Liu J, Singh H, White PF. Electroencephalogram bispectral analysis predicts the depth of midazolaminduced sedation. Anesthesiology 1996, 84, 64-69
  24. Rampil IJ, Sasse FJ, Smith NT, Hoff BH, Flemming DC. Spectral edge frequency-a new correlate of anesthetic depth. Anesthesiology 1980, 53, 512-517
  25. Watson KR, Shah MV. Clinical comparison of 'single agent' anaesthesia with sevoflurane versus target controlled infusion of propofol. Br J Anaesth 2000, 85, 541-546
  26. Nolan AM, Reid J, Grant S. The effects of halothane and nitrous oxide on the pharmacokinetics of propofol in dogs. J Vet Pharmacol Ther 1993, 16, 335-342
  27. Haberthur C, Lehmann F, Ritz R. Assessment of depth of midazolam sedation using objective parameters. Intensive Care Med 1996, 22, 1385-1390
  28. Murrell JC, Johnson CB, White KL, Taylor PM, Haberham ZL, Waterman-Pearson AE. Changes in the EEG during castration in horses and ponies anaesthetized with halothane. Vet Anaesth Analg 2003, 30, 138-146
  29. Levy WJ, Shapiro HM, Maruchak G, Meathe E. Automated EEG processing for intraoperative monitoring : a comparison of techniques. Anesthesiology 1980, 53, 223-236
  30. Martin-Cancho MF, Carrasco-Jimenez MS, Lima JR, Ezquerra LJ, Crisostomo V, Uson-Gargallo J. Assessment of the relationship of bispectral index values, hemodynamic changes, and recovery times associated with sevoflurane or propofol anesthesia in pigs. Am J Vet Res 2004, 65, 409-416
  31. Doi M, Gajraj RJ, Mantzaridis H, Kenny GN. Relationship between calculated blood concentration of propofol and electrophysiological variables during emergence from anaesthesia: comparison of bispectral index, spectral edge frequency, median frequency and auditory evoked potential index. Br J Anaesth 1997, 78, 180-184
  32. Sebel PS, Bowles SM, Saini V, Chamoun N. EEG bispectrum predicts movement during thiopental/isoflurane anesthesia. J Clin Monit 1995, 11, 83-91
  33. Steiss JE. A survey of current techniques in veterinary electrodiagnostics: EEG, spinal evoked and brainstem auditory evoked potential recording. Vet Res Commun 1988, 12, 281-288
  34. 노규정, 길호영. 진정의 평가. In: 대한정맥마취학회 (ed.). 진정. pp. 9-15, 의학문화사, 서울, 2004