Differential effects of sevoflurane and propofol on an electroretinogram and visual evoked potentials

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The purpose of this study was to simultaneously evaluate the effects of sevoflurane and propofol on an electroretinogram (ERG) and visual evoked potentials (VEPs). Twenty-four patients scheduled for elective surgery under general anesthesia were allocated randomly to receive either sevoflurane (group S) or propofol (group P). An ERG and VEPs were recorded in an awake state and during anesthesia with three different minimum alveolar concentrations (MAC; 0.5, 1.0, and 1.5) of sevoflurane in group S or with three different effect-site concentrations (Ce) of 2, 3, and 4 μg/ml by using a target-controlled infusion technique in group P. Sevoflurane and propofol had little effect on amplitudes of the ERG b-wave. Sevoflurane significantly attenuated the amplitudes of VEP N75-P100 at 0.5, 1.0, and 1.5 MAC. Propofol did not significantly decrease the amplitude of VEPs at Ce of 2 or 3 μg/ml but significantly decreased it at Ce of 4 μg/ml. In summary, propofol and sevoflurane at clinical concentrations had little effect on the amplitude of an ERG. Sevoflurane attenuated the amplitudes of VEPs even at low concentrations. Propofol also attenuated the amplitudes of VEPs to a lesser extent compared to sevoflurane.

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  1. 1.

    Wright JE, Arden G, Jones BR. Continuous monitoring of the visually evoked response during intra-orbital surgery. Trans Ophthalmol Soc UK. 1973;93:311–4.

  2. 2.

    Neuloh G. Time to revisit VEP monitoring? Acta Neurochir (Wien). 2010;152:649–50.

  3. 3.

    Kodama K, Goto T, Sato A, Sakai K, Tanaka Y, Hongo K. Standard and limitation of intraoperative monitoring of the visual evoked potential. Acta Neurochir (Wien). 2010;152:643–8.

  4. 4.

    Sasaki T, Itakura T, Suzuki K, Kasuya H, Munakata R, Muramatsu H, Ichikawa T, Sato T, Endo Y, Sakuma J, Matsumoto M. Intraoperative monitoring of visual evoked potential: introduction of a clinically useful method. J Neurosurg. 2010;112:273–84.

  5. 5.

    Hayashi H, Kawaguchi M. Intraoperative monitoring of flash visual evoked potential under general anesthesia. Korean J Anesthesiol. 2017;70:127–35.

  6. 6.

    Nakagawa I, Hidaka S, Okada H, Kubo T, Okamura K, Kato T. Effects of sevoflurane and propofol on evoked potentials during neurosurgical anesthesia (in Japanese with English abstract). Masui (Jpn J Anesthesiol). 2006;55:692–8.

  7. 7.

    Banoub M, Tetzlaff JE, Schubert A. Pharmacologic and physiologic influences affecting sensory evoked potentials: implications for perioperative monitoring. Anesthesiology. 2003;99:716–37.

  8. 8.

    Iohom G, Whyte A, Flynn T, O’Connor G, Shorten G. Postoperative changes in the full-field electroretinogram following sevoflurane anaesthesia. Eur J Anaesthesiol. 2004;21:272–8.

  9. 9.

    Tanskanen P, Kylma T, Kommonen B, Kerhunen U. Propofol influences the electroretinogram to a lesser degree than thiopentone. Acta Anaesthesiol Scand. 1996;40:480–5.

  10. 10.

    Yagi M, Tahiro C, Yoshiya I. Changes in the electroretinogram during enflurane anesthesia (in Japanese with English abstract). Masui (Jpn J Anesthesiol). 1989;38:1438–43.

  11. 11.

    Maguire AM, Kumar N, Parker JL, Rowbotham DJ, Thompson JP. Comparison of effects of remifentanil and alfentanil on cardiovascular response to tracheal intubation in hypertensive patients. Br J Anaesth. 2001;86:90–3.

  12. 12.

    Riva CE, Grunwald JE, Petrig BL. Autoregulation of human retinal blood flow. An investigation with laser Doppler velocimetry. Investig Ophthalmol Vis Sci. 1986;27:1706–12.

  13. 13.

    Lassen NA. Cerebral blood flow and oxygen consumption in man. Physiol Rev. 1959;39:183–238.

  14. 14.

    Tanskanen P, Kylma T, Kommonen B, Karhunen U. Propofol influences the electroretinogram to a lesser degree than thiopentone. Acta Anaesthesiol Scand. 1996;40:480–5.

  15. 15.

    Holder GE. Electrophysiological assessment of optic nerve disease. Eye (Lond). 2004;18:1133–43.

  16. 16.

    Shigeto H, Tobimatsu S, Yamamoto T, Kobayashi T, Kato M. Visual evoked cortical magnetic responses to checkerboard pattern reversal stimulation: a study on the neural generators of N75, P100 and N145. J Neurol Sci. 1998;156:186–94.

  17. 17.

    Guillery RW, Sherman SM. Thalamic relay functions and their role in corticocortical communication: generalizations from the visual system. Neuron. 2002;33:163–75.

  18. 18.

    Wakasugi M, Hirota K, Roth SH, Ito Y. The effects of general anesthetics on excitatory and inhibitory synaptic transmission in area CA1 of the rat hippocampus in vitro. Anesth Analg. 1999;88:676–80.

  19. 19.

    Krasowski MD, Harrison NL. General anaesthetic actions on ligand-gated ion channels. Cell Mol Life Sci. 1999;55:1278–303.

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Correspondence to Satoshi Tanaka.

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Tanaka, R., Tanaka, S., Ichino, T. et al. Differential effects of sevoflurane and propofol on an electroretinogram and visual evoked potentials. J Anesth (2020).

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  • Electroretinogram
  • Visual evoked potentials
  • Sevoflurane
  • Propofol