The impact of age on bispectral index values and EEG bispectrum during anaesthesia with desflurane and halothane in children

Abstract

The relationship between end-tidal sevoflurane concentration, bispectral index (BIS) and the EEG bispectrum in children appears to be age dependent. The aim of this study was to quantify the BIS values at 1 MAC (minimum alveolar concentration) for desflurane and halothane, and explore the relationship with age for these anaesthetic agents in children. ECG, EEG and BIS were recorded continuously in 90 children aged 6-170 months requiring anaesthesia for elective surgery. Fifty children were anaesthetized with desflurane, and 40 children with halothane. Recordings were performed through to a steady state of 2 MAC, and thereafter at 1 and 0.5 MAC, respectively. The bispectrum of the EEG was estimated using MATLAB(c) software. A multiple correspondence analysis (MCA) was used. At a steady state of 1 MAC, BIS values were significantly higher with halothane 62 (43-80) than desflurane 34 (18-64). BIS values were significantly correlated with age in both groups: DES (r(2)=0.57; P<0.01) and HALO (r(2)=0.48; P<0.01). Changes in position in the structured model of the MCA (dependent on the pattern of the EEG bispectrum) were different for the two volatile anaesthetic agents. In children, BIS values are linked to age irrespective of the volatile anaesthetic agent used. The difference in BIS values for different agents at the same MAC can be explained by the specific effect on the EEG bispectrum induced by each anaesthetic agent, bringing into question the ability of the EEG bispectrum to accurately determine the depth of anaesthesia.