Biphasic EEG changes in relation to loss of consciousness during inductionwith thiopental, propofol, etomidate, midazolam or sevoflurane

The time course of four EEG effect variables, amplitude in the 2-5 Hz and i n the 11-15 Hz band, spectral edge frequency 95% (SEF95), and bispectral in dex (BIS), in response to increasing concentrations of thiopental, propofol , etomidate, midazolam, or sevoflurane during a 10 min induction of anaesth esia was studied in 25 patients to determine the existence of a biphasic ef fect and to study the relationship of the EEG effect to the moment of loss of consciousness. A biphasic effect, that is, an initial increase of the ef fect variable followed by a decrease at higher concentrations, during the t ransition from consciousness to unconsciousness was found in EEG amplitude (both frequency bands) and in SEF95 for all anaesthetics except midazolam. There was a concentration-related decrease in BIS for all anaesthetics. The re was no consistent relationship between the time of occurrence of the pea k EEG effect, or the value of the EEG variable and the moment of loss of co nsciousness. With rapidly changing drug concentrations during the induction of anaesthesia, none of these EEG effect variables could be correlated to the moment of loss of consciousness.