EFFECTS OF INCREASING DOSES OF ALFENTANIL, FENTANYL AND MORPHINE ON MID-LATENCY AUDITORY EVOKED POTENTIALS

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Abstract
We have studied dose-dependent effects of alfentanil, fentanyl and morphine on mid-latency auditory evoked potentials (MLAEP). Anaesthesia was induced with alfentanil 100 μg kg−1 every 5 mm to a total dose of 500 μg kg−1 (group I, n = 10), fentanyl 10 μg kg−1 every 7 min to a total dose of 50 μg kg−1 (group II, n = 10) or morphine 1 mg kg−1 for induction and 0.5 mg kg−1 every 15 min to a tota l dose of 3mg kg−1 (group III, n = 10). MLAEP were recorded before and 3–15 min after every opioid dose on vertex (positive) and mastoids on both sides (negative). Latencies of the peaks V, Na, Pa, Nb, P1 (ms) and amplitudes Na/Pa, Pa/Nb and Nb/P1 (μV) were measured. Fast-Fourier transformation was used to calculate power spectra of the AEP. In the awake state, MLAEP had high peak-to-peak amplitudes and a periodic waveform. Power spectra indicated high energy in the 30–40 Hz frequency range. During general anaesthesia with increasing doses of alfentanil, fentanyl and morphine, the brainstem response V was stable. There was a marked increase only in latency and decrease in amplitude of P1. In contrast, for the early cortical potentials Na and Pa, only small increases in latencies and decreases in amplitudes were observed. After the largest doses of affentanil (500 μg kg−1), fentanyl (50 μg kg−1) and morphine (3 mg kg−1) Na, Pa and Nb showed a similar pattern as in awake patients. In the power spectra, high energy persisted in the 30-Hz frequency range. There were no dose-dependent effects of opioids on MLAEP and no differences between alfentanil, fentanyl, and morphine could be found. (Br. J. Anaesth. 1993; 71: 622–628)

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