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Are Slow Waves of Intracranial Pressure Suppressed by General Anaesthesia?

  • Despina Afroditi LalouEmail author
  • Marek Czosnyka
  • Joseph Donnelly
  • Andrea Lavinio
  • John D. Pickard
  • Matthew Garnett
  • Zofia Czosnyka
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 126)

Abstract

Objectives: Slow waves of intracranial pressure (ICP) are spontaneous oscillations with a frequency of 0.3–4 cycles/min. They are often associated with pathological conditions, following vasomotor activity in the cranial enclosure. This study quantifies the effects of general anaesthesia (GA) on the magnitude of B-waves compared with natural sleep and the conscious state.

Materials and methods: Four groups of 30 patients each were formed to assess the magnitude of slow waves. Group A and group B consisted of normal pressure hydrocephalus (NPH) patients, each undergoing cerebrospinal fluid (CSF) infusion studies, conscious and under GA respectively. Group C comprised conscious, naturally asleep hydrocephalic patients undergoing overnight ICP monitoring; group D, which included deeply sedated head injury patients monitored in the intensive care unit (ICU), was compared with group C.

Results: The average amplitude for group A patients was higher (0.23 ± 0.10 mmHg) than that of group B (0.15 ± 0.10 mmHg; p = 0.01). Overnight magnitude of slow waves was higher in group C (0.20 ± 0.13 mmHg) than in group D (0.11 ± 0.09 mmHg; p = 0.002).

Conclusion: Slow waves of ICP are suppressed by GA and deep sedation. When using slow waves in clinical decision-making, it is important to consider the patients’ level of consciousness to avoid incorrect therapeutic and management decisions.

Keywords

General anesthesia Slow waves B-waves Intracranial pressure Hydrocephalus 

Notes

Conflicts of interest statement

We declare that we have no conflicts of interest.

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Despina Afroditi Lalou
    • 1
    Email author
  • Marek Czosnyka
    • 1
  • Joseph Donnelly
    • 1
  • Andrea Lavinio
    • 2
  • John D. Pickard
    • 1
  • Matthew Garnett
    • 1
  • Zofia Czosnyka
    • 1
  1. 1.Division of Neurosurgery, Department of Clinical NeuroscienceCambridge University HospitalCambridgeUK
  2. 2.Neurosciences Critical Care Unit, Department of AnaesthesiaCambridge University Hospitals NHS Foundation TrustCambridgeUK

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