A Preliminary Study of Volatile Agents or Total Intravenous Anesthesia for Neurophysiological Monitoring During Posterior Spinal Fusion in Adolescents With Idiopathic Scoliosis

Martin, David P.; Bhalla, Tarun; Thung, Arlyne; Rice, Julie; Beebe, Allan; Samora, Walter; Klamar, Jan; Tobias, Joseph D.

doi:10.1097/brs.0000000000000550

Cited by 52 publications

(43 citation statements)

References 18 publications

(5 reference statements)

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“…As has been noted in our previous work, the use of the volatile anesthetic agent, desflurane, in combination with a potent opioid (sufentanil or remifentanil) provides an effective intraoperative anesthetic while allowing for effective neurophysiological monitoring and providing a rapid emergence at the conclusion of the case [39].…”

Section: Discussionmentioning

confidence: 73%

Anesthetic Management of an Adolescent With Diamond-Blackfan Syndrome During Posterior Spinal Fusion

et al. 2015

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Diamond-Blackfan syndrome (DBS) is a rare autosomal dominant ribosomal disorder. Patients present primarily with severe hypoplastic anemia and reticulocytopenia. Due to the craniofacial defects, cardiac pathology, short stature, and skeletal abnormalities, surgical and anesthetic care are frequently required. The associated structural anomalies and end-organ involvement may impact the perioperative care. We present an 18-year-old adolescent with Diamond-Blackfan anemia (DBA) who required anesthetic care for posterior spinal fusion. Previous reports of anesthetic care for these patients are reviewed, the end-organ involvement is discussed, and options for anesthetic care are presented.

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Section: Discussionmentioning

confidence: 73%

Anesthetic Management of an Adolescent With Diamond-Blackfan Syndrome During Posterior Spinal Fusion

et al. 2015

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“…Our technique was chosen based on our usual clinical practice to facilitate neurophysiological monitoring of spinal cord integrity [6]. Successful outcomes have been reported with both intravenous-based (total intravenous anesthesia or TIVA) and volatile-based techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Extreme care was taken to ensure that all pressure points were padded and the patient was in as neutral a position as her body would allow. To facilitate neurophysiological monitoring, maintenance of anesthesia included desflurane (0.5 -0.6 minimum alveolar concentration) titrated to maintain the BIS at 50 -60 and a remifentanil infusion (0.1 -0.3 µg/kg/min) [6]. Phenylephrine was used to maintain the mean arterial pressure (MAP) and NIRS values at baseline with an MAP in the range of 75 -85 mmHg.…”

Section: Case Reportmentioning

confidence: 99%

Anesthetic Management During Posterior Spinal Fusion in a Patient With Moyamoya

et al. 2018

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Moyamoya disease is an arteriopathy of the vasculature of the central nervous system that predisposes patients to cerebrovascular ischemia and thrombotic strokes. It is characterized by a progressive narrowing of the intracranial component of the internal carotid arteries as well as the proximal branches of the anterior and middle cerebral arteries thereby predisposing patients to episodes of cerebrovascular insufficiency. Moyamoya disease adds an additional level of complexity to the anesthetic care of patients undergoing major surgical procedures related to concerns of maintaining adequate cerebral perfusion and oxygenation. These patients may present with a history of transient ischemic attacks or cerebrovascular accidents with resultant neurological deficits, cognitive delay and seizures at baseline. We present an 18-year-old woman with moyamoya disease who required anesthetic care during a posterior spinal fusion for a neuromuscular disorder. Physiological parameter management intraoperatively is discussed and options for anesthetic care are presented with an emphasis on the use of near infrared spectroscopy to monitor cerebral oxygenation.

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“…Per our usual routine, we use 0.5 minimum alveolar concentrations (MAC) of the volatile anesthetic agent, desflurane, supplemented with a benzodiazepine (midazolam) as needed to ensure amnesia with the potent opioid, sufentanil, to provide analgesia and control the hemodynamic response to surgical stimulation. This combination allows for rapid awakening should there be changes in the MEP or SSEP monitoring [18].…”

Section: Discussionmentioning

confidence: 99%

“…Two peripheral venous cannulas and an arterial cannula were placed. Per our usual practice to allow for neurophysiological monitoring during spinal surgery, anesthesia was maintained with desflurane titrated to maintain the bispectral index (BIS) at 50 -60 and a sufentanil infusion of 0.1 -0.3 µg/kg/h to maintain the mean arterial pressure at 55 -70 mm Hg [18]. Baseline neurophysiological monitoring including motor-evoked potentials (MEP) and somatosensory-evoked potentials (SSEPs) was obtained.…”

Section: Case Reportmentioning

confidence: 99%

6p25 Deletion and Anesthetic Implications During Growing Rod Insertion for Early Onset Scoliosis

et al. 2017

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6p25 is a rare yet clinically identifiable disorder that results from the deletion of the short arm of chromosome 6. Due to the craniofacial, central nervous system, renal, cardiac, and skeletal abnormalities, anesthetic care may be required during various surgical interventions. The associated structural anomalies and end-organ involvement may impact the perioperative care. We present a 4-year-old girl with subtelomeric 6p25 deletion who required anesthetic care during placement of growing rods to treat progressive scoliosis. A review of literature was performed, the end-organ involvement was discussed, and options for anesthetic care were presented.

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A Preliminary Study of Volatile Agents or Total Intravenous Anesthesia for Neurophysiological Monitoring During Posterior Spinal Fusion in Adolescents With Idiopathic Scoliosis

Abstract: 2.

Cited by 52 publications

References 18 publications

Anesthetic Management of an Adolescent With Diamond-Blackfan Syndrome During Posterior Spinal Fusion

Anesthetic Management of an Adolescent With Diamond-Blackfan Syndrome During Posterior Spinal Fusion

Anesthetic Management During Posterior Spinal Fusion in a Patient With Moyamoya

6p25 Deletion and Anesthetic Implications During Growing Rod Insertion for Early Onset Scoliosis

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