Does the EEG Measure Therapeutic Opioid Drug Effect?

  • V. Billard
  • S. L. Shafer

Abstract

In this chapter we discuss the extent to which the EEG reflects therapeutic opioid drug effect. For the hypnotics, the EEG has been used to control the depth of anesthesia via closed-loop administration. These systems will be discussed in the chapters by Professors Schwilden [1, 2] (median frequency) and Kenny (auditory-evoked potentials). That computerized systems are able to satisfactorily administer hypnotics based on direct feedback from EEG-derived measures suggests that the EEG is, in fact, a very reasonable measure of hypnotic drug effect. Thus, we will focus here on the EEG as a measure of the therapeutic effect of opioids.

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References

  1. 1.
    Schwilden H, Schuttler J, Stoeckel H (1987) Closed-loop feedback control of methohexital anesthesia by quantitative EEG analysis in humans. Anesthesiology 67: 341–347PubMedCrossRefGoogle Scholar
  2. 2.
    Schwilden H, Stoeckel H, Schuttler J (1989) Closed-loop feedback control of propofol anaesthesia by quantitative EEG analysis in humans. Br J Anaesth 62: 290–296PubMedCrossRefGoogle Scholar
  3. 3.
    Ausems ME, Hug CC, Stanski DR, Burm AGL (1986) Plasma concentrations of alfentanil required to supplement nitrous oxide anesthesia for general surgery. Anesthesiology 65: 362–373PubMedCrossRefGoogle Scholar
  4. 4.
    Scott JC, Ponganis KV, Stanski DR (1985) EEG quantitation of narcotic effect: the comparative pharmacodynamics of fentanyl and alfentanil. Anesthesiology 62: 234–241PubMedCrossRefGoogle Scholar
  5. 5.
    Scott JC, Stanski DR (1987) Decreased fentanyl/alfentanil does requirement with increasing age: a pharmacodynamic basis. J Pharmacol Exp Ther 240: 159–166PubMedGoogle Scholar
  6. 6.
    Scott JC, Cooke JE, Stanski DR (1991) Electroencephalographic quantitation of opioid effect: comparative pharmacodynamics of fentanyl and sufentanil. Anesthesiology 74: 34–42PubMedCrossRefGoogle Scholar
  7. 7.
    Dutton RC, Smith WD, Smith NT (1990) Does the EEG predict anesthetic depth better than cardiovascular variables? Anesthesiology 73: A532 (abstract)CrossRefGoogle Scholar
  8. 8.
    Dutton RC, Smith WD, Smith NT (1991) EEG prediction of awareness during anesthesia with combinations of isoflurane, fentanyl, and N20. Anesthesiology 75: A448 (abstract)CrossRefGoogle Scholar
  9. 9.
    Long CW, Shah NK, Loughlin C, Spydell J, Bedford RF (1989) A comparison of EEG determinants of near-awakening from isoflurane and fentanyl anesthesia. Spectral edge, median power frequency, and delta ratio. Anesth Analg 69: 169–173Google Scholar
  10. 10.
    Sidi A, Halimi P, Cotev S (1990) Estimating anesthetic depth by electroencephalography during anesthetic induction and intubation in patients undergoing cardiac surgery. J Clin Anesth 2: 101–107PubMedCrossRefGoogle Scholar
  11. 11.
    Smith NT, Westover CJ jr, Quinn M, Benthuysen JL, Dec Sliver H, Sanford TJ jr (1985) An electroencephalographic comparison of alfentanil with other narcotics and with thiopental. J Clin Monit 1: 236–244PubMedCrossRefGoogle Scholar
  12. 12.
    Shafer A, Sung ML, White PF (1986) Pharmacokinetics and pharmacodynamics of alfentanil infusions during general anesthesia. Anesth Analg 65: 1021–1028PubMedCrossRefGoogle Scholar
  13. 13.
    Hug CC jr Hall RI, Angert KC, Reeder DA, Moldenhauer CC (1988) Alfentanil plasma concentration v. effect relationships in cardiac surgical patients. Br J Anaesth 61: 435–440CrossRefGoogle Scholar
  14. 14.
    Gregg KM, Varvel JR, Shafer SL (1992) Application of semilinear canonical correlation to the measurement of opioid drug effect. J Pharmacokinet Biopharm 20: 611–635PubMedCrossRefGoogle Scholar
  15. 15.
    Shafer SL, Varvel JR (1991) Pharmacokinetics, pharmacodynamics, and rational opioid selection. Anesthesiology 74: 53–63PubMedCrossRefGoogle Scholar
  16. 16.
    Sebel PS, Glass PS, Fletcher JE, Murphy MR, Gallagher C, Quill T (1992) Reduction of the MAC of desflurane with fentanyl. Anesthesiology 76: 52–59PubMedCrossRefGoogle Scholar
  17. 17.
    McEwan AI, Smith C, Dyar O, Goodman D, Smith LR, Glass PS (1993) Isoflurane minimum alveolar concentration reduction by fentanyl. Anesthesiology 78: 864–869PubMedCrossRefGoogle Scholar
  18. 18.
    Brunner MD, Braithwaite P, Jhaveri R, McEwan AI, Goodman DK, Smith LR, Glass PS (1994) MAC reduction of isoflurane by sufentanil. Br J Anaesth 72: 42–46PubMedCrossRefGoogle Scholar
  19. 19.
    Glass PS, Doherty M, Jacobs JR, Goodman D, Smith LR (1993) Plasma concentration of fentanyl, with 70% nitrous oxide, to prevent movement at skin incision. Anesthesiology 78: 842–847PubMedCrossRefGoogle Scholar
  20. 20.
    Lemmens, HJM, Dyck JB, Shafer SL, Stanski DR (1994) Pharmacokinetic/dynamic modeling in drug development: application to the investigational opioid trefentanil. Clin Pharmacol Ther (in press)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • V. Billard
  • S. L. Shafer

There are no affiliations available

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