ANALYSIS OF THE EEG BISPECTRUM, AUDITORY-EVOKED POTENTIALS AND THE EEG POWER SPECTRUM DURING REPEATED TRANSITIONS FROM CONSCIOUSNESS TO UNCONSCIOUSNESS

We have compared the auditory evoked potential (AEP) index (a numerica l index derived from the AEP), 95% spectral edge frequency (SEF), medi an frequency (MF) and the bispectral index (BIS) during alternating pe riods of consciousness and unconsciousness produced by target-controll ed infusions of propofol. We studied 12 patients undergoing hip or kne e replacement under spinal anaesthesia. During periods of consciousnes s and unconsciousness, respective mean values for the four measurement s were: AEP index, 60.8 (so 13.7) and 37.6 (6.5); BIS, 85.1 (8.2) and 66.8 (10.5); SEF, 24.2 (2.2) and 18.7 (2.1); and MF, 10.9 (3.3) and 8. 8 (2.0). Threshold values with a specificity of 100% for a state of un consciousness were: AEP index, 37 (sensitivity 52%); BIS, 55 (sensitiv ity 15%); and SEF, 16.0 (sensitivity 9%). There was no recorded value for MF that was 100% specific for unconsciousness. Of the four measure ments, only AEP index demonstrated a significant difference (P < 0.05) between all mean values 1 min before recovery of consciousness and al l mean values 1 min after recovery of consciousness. Our findings sugg est that of the four electrophysiological variables, AEP index was bes t at distinguishing the transition from unconsciousness to consciousne ss.