We sought to compare effects of remifentanil- and fentanyl-based anesthesia on the morphology of somatosensory evoked potentials (SSEPs) and speed of recovery from anesthesia. Forty-one patients undergoing spinal surgery and requiring intraoperative monitoring of SSEPs were randomized into two groups. In Group 1, anesthesia was induced with sodium thiopental and maintained with fentanyl, 50% nitrous oxide in oxygen, and 0.5%--0.75% isoflurane. In Group 2, anesthesia was induced with sodium thiopental and maintained with remifentanil, 50% oxygen in air, and 0.5%--0.75% isoflurane. The variables compared included hemodynamic changes during the induction and intubation, the interval from the end of anesthesia to extubation, intraoperative blood loss and fluid administration, and changes in latency and amplitude of the P37--N45 component of posterior tibial nerve somatosensory evoked potentials and the N20--P24 component of median nerve somatosensory evoked potentials. The two groups were matched for demographics, ASA physical status, and duration of surgery. Hemodynamic profiles after the induction and intubation were similar. There were significant differences between groups in time intervals from the end of anesthesia to extubation (15.3 +/- 12.8 vs 5.3 +/- 2.3 min; P = 0.0001) and ability to follow verbal commands (14.6 +/- 11.9 vs 4.5 +/- 2.4 min; P = 0.0001), with the Remifentanil group showing earlier recovery. Variability (coefficient of variation) of P37--N45 latency was greater (0.026 vs 0.014; P = 0.001) in the Fentanyl group.
This technique can be used to assess potential abnormalities in primary afferent neural pathways innervating the rectum in several neurodegenerative and functional pain disorders.
It has been five years since The Neurodiagnostic Journal published the article, "ABRET: A Historical Review: Building the Future on a Strong Foundation" (Walbert and Ahn-Ewing 2009). Since that time, ABRET has been busy. With acknowledgment and honor ABRET recognizes where it has been. The combined experience of the past allows ABRET to proactively and creatively look at ways to maintain relevancy in the continuously evolving field of neurodiagnostics. Many outstanding technologists and physicians from both the past and present have successfully placed ABRET in a position where it can explore new opportunities for growth and exam development. This article will focus on the exciting initiatives that ABRET is developing not only for implementation now, but into the future as well.
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