Differences in the topographical distribution of EEG activity during surgical anaesthesia and on emergence from volatile anesthetics

Computerized processing of a 16 channel EEG allows mapping and display of cortical electrical activity in a useful mode for intraoperative monitoring. We studied the topographical distribution of EEG-activity displayed as spectral maps comparing inhalational anaesthesia with isoflurane or enflurane during surgical anaesthesia and emergence. Two groups of nine patients each were anaesthetized with one of the two regimens. The EEG patterns during steady state end-tidal concentrations of isoflurane (0.7-1.1%) or enflurane (0.8-1.3%) showed highest activity in the frontal and occipital areas. At near awakening the frontal and occipital dominance of delta activity disappeared in both groups and was replaced by homogeneous delta activity over the entire cortex; variations in the topographical distribution of enflurane and isoflurane were recorded in the other spectral bands. We conclude that changes in topographic EEG patterns observed during the transition from surgical anaesthesia to emergence, in particular the disappearance of frontal and occipital dominance of delta activity common to isoflurane and enflurane, may serve to detect undesirably light levels of anaesthesia.