Which SSEP waveforms are most adversely affected by anesthesia?

The correct choice indicates that cortical waveforms, such as N20/P23 and P37/N45, are most adversely affected by anesthesia. This is primarily due to the influence of anesthesia on the central nervous system. Anesthesia can depress the activity of the cerebral cortex, leading to reduced amplitude and delayed latency of these waveforms. Cortical responses are highly sensitive to changes in neuronal activity, which is exactly what anesthesia induces, often resulting in a dampening effect on these signals.

Cortical waveforms reflect the processing of sensory information by the brain. Anesthesia alters neurotransmitter release and neural excitability, which can diminish the integrity of these cortical signals. In contrast, peripheral nerve and subcortical waveforms are typically less affected by the systemic effects of anesthesia since they are primarily measured from more peripheral structures or subcortical areas where the effects might not be as profound. Therefore, while all waveforms can be influenced to some degree by anesthesia, cortical waveforms demonstrate the most significant changes.