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Are Slow Waves of Intracranial Pressure Suppressed by General Anaesthesia?

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Book cover Intracranial Pressure & Neuromonitoring XVI

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 126))

Abstract

Objectives: Slow waves of intracranial pressure (ICP) are spontaneous oscillations with a frequency of 0.3–4 cycles/min. They are often associated with pathological conditions, following vasomotor activity in the cranial enclosure. This study quantifies the effects of general anaesthesia (GA) on the magnitude of B-waves compared with natural sleep and the conscious state.

Materials and methods: Four groups of 30 patients each were formed to assess the magnitude of slow waves. Group A and group B consisted of normal pressure hydrocephalus (NPH) patients, each undergoing cerebrospinal fluid (CSF) infusion studies, conscious and under GA respectively. Group C comprised conscious, naturally asleep hydrocephalic patients undergoing overnight ICP monitoring; group D, which included deeply sedated head injury patients monitored in the intensive care unit (ICU), was compared with group C.

Results: The average amplitude for group A patients was higher (0.23 ± 0.10 mmHg) than that of group B (0.15 ± 0.10 mmHg; p = 0.01). Overnight magnitude of slow waves was higher in group C (0.20 ± 0.13 mmHg) than in group D (0.11 ± 0.09 mmHg; p = 0.002).

Conclusion: Slow waves of ICP are suppressed by GA and deep sedation. When using slow waves in clinical decision-making, it is important to consider the patients’ level of consciousness to avoid incorrect therapeutic and management decisions.

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Conflicts of interest statement

We declare that we have no conflicts of interest.

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Authors and Affiliations

  1. Division of Neurosurgery, Department of Clinical Neuroscience, Cambridge University Hospital, Cambridge, UK

    Despina Afroditi Lalou, Marek Czosnyka, Joseph Donnelly, John D. Pickard, Matthew Garnett & Zofia Czosnyka

  2. Neurosciences Critical Care Unit, Department of Anaesthesia, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

    Andrea Lavinio

Authors
  1. Despina Afroditi Lalou
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  2. Marek Czosnyka
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  3. Joseph Donnelly
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  4. Andrea Lavinio
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  5. John D. Pickard
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  6. Matthew Garnett
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  7. Zofia Czosnyka
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Corresponding author

Correspondence to Despina Afroditi Lalou .

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Editors and Affiliations

  1. Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA

    Thomas Heldt

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Lalou, D.A. et al. (2018). Are Slow Waves of Intracranial Pressure Suppressed by General Anaesthesia?. In: Heldt, T. (eds) Intracranial Pressure & Neuromonitoring XVI. Acta Neurochirurgica Supplement, vol 126. Springer, Cham. https://doi.org/10.1007/978-3-319-65798-1_27

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  • DOI: https://doi.org/10.1007/978-3-319-65798-1_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65797-4

  • Online ISBN: 978-3-319-65798-1

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