Propofol anaesthesia alters somatosensory evoked cortical potentials

Maurette, P.; Simeon, F.; Castagnera, L; Esposito, Joseph L.; Macouillard, G.; Heraut, L

doi:10.1111/j.1365-2044.1988.tb09068.x

Cited by 28 publications

(6 citation statements)

References 4 publications

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“…In addition, over the study period, there were no identified cases fulfilling the criteria for significant SSEP changes, suggesting that this form of monitoring may be less vulnerable to interference by external factors intraoperatively. This was seen in contrast to previous reports [ 11 , 12 ].…”

Section: Discussioncontrasting

confidence: 99%

Systematic re-evaluation of intraoperative motor-evoked potential suppression in scoliosis surgery

Tan

Raman

et al. 2018

Scoliosis

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BackgroundMotor- (MEP) and somatosensory-evoked potentials (SSEP) are susceptible to the effects of intraoperative environmental factors.MethodsOver a 5-year period, 250 patients with adolescent idiopathic scoliosis (AIS) who underwent corrective surgery with IOM were retrospectively analyzed for MEP suppression (MEPS).ResultsOur results show that four distinct groups of MEPS were encountered over the study period. All 12 patients did not sustain any neurological deficits postoperatively. However, comparison of groups 1 and 2 suggests that neither the duration of anesthesia nor speed of surgical or anesthetic intervention were associated with recovery to a level beyond the criteria for MEPS. For group 3, spontaneous MEPS recovery despite the lack of surgical intervention suggests that anesthetic intervention may play a role in this process. However, spontaneous MEPS recovery was also seen in group 4, suggesting that in certain circumstances, both surgical and anesthetic intervention was not required. In addition, neither the duration of time to the first surgical manoeuver nor the duration of surgical manoeuver to MEPS were related to recovery of MEPS. None of the patients had suppression of SSEPs intraoperatively.ConclusionThis study suggests that in susceptible individuals, MEPS may rarely occur unpredictably, independent of surgical or anesthetic intervention. However, our findings favor anesthetic before surgical intervention as a proposed protocol. Early recognition of MEPS is important to prevent false positives in the course of IOM for spinal surgery.

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Section: Discussioncontrasting

confidence: 99%

Systematic re-evaluation of intraoperative motor-evoked potential suppression in scoliosis surgery

Tan

Raman

et al. 2018

Scoliosis

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“…It has been reported that muscle MEPs are suppressed by midazolam, volatile anesthetics, and even propofol in a dose-dependent manner. 4,9,10,12,14,16,20,21,25,28,29 Since muscle MEPs are known to be sensitive to volatile anesthetics, intravenous anesthetics are preferentially used during muscle MEP monitoring. 12,25 The bispectral index (BIS) is one of several methods used to monitor the depth of anesthesia.…”

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confidence: 99%

The influence of depth of anesthesia on motor evoked potential response during awake craniotomy

Ohtaki¹,

Akiyama²,

Kanno³

et al. 2017

JNS

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OBJECTIVE Motor evoked potentials (MEPs) are a critical indicator for monitoring motor function during neurological surgery. In this study, the influence of depth of anesthesia on MEP response was assessed. METHODS Twenty-eight patients with brain tumors who underwent awake craniotomy were included in this study. From a state of deep anesthesia until the awake state, MEP amplitude and latency were measured using 5-train electrical bipolar stimulations on the same site of the precentral gyrus each minute during the surgery. The depth of anesthesia was evaluated using the bispectral index (BIS). BIS levels were classified into 7 stages: < 40, and from 40 to 100 in groups of 10 each. MEP amplitude and latency of each stage were compared. The deviation of the MEP measurements, which was defined as a fluctuation from the average in every BIS stage, was also considered. RESULTS A total of 865 MEP waves in 28 cases were evaluated in this study. MEP amplitude was increased and latency was decreased in accordance with the increases in BIS level. The average MEP amplitudes in the > 90 BIS level was approximately 10 times higher than those in the < 40 BIS level. Furthermore, the average MEP latencies in the > 90 BIS level were 1.5-3.1 msec shorter than those in the < 60 BIS level. The deviation of measured MEP amplitudes in the > 90 BIS level was significantly stabilized in comparison with that in the < 60 BIS level. CONCLUSIONS MEP amplitude and latency were closely correlated with depth of anesthesia. In addition, the deviation in MEP amplitude was also correlated with depth of anesthesia, which was smaller during awake surgery (high BIS level) than during deep anesthesia. Therefore, MEP measurement would be more reliable in the awake state than under deep anesthesia.

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“…4 However, tcMEP recordings are markedly affected by anaesthetics such as nitrous oxide, barbiturates and halogenated agents and also by neuromuscular blocking agents, hypothermia and variations of blood carbon dioxide. 5 6 Propofol in low doses decreases the amplitude of the early components of the SEP, 7 but its effects on MEP have not been fully investigated 5…”

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confidence: 99%

Influence of propofol concentrations on multipulse transcranial motor evoked potentials

Nathan

Tabaraud

Lacroix

et al. 2003

British Journal of Anaesthesia

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Propofol anaesthesia alters somatosensory evoked cortical potentials

Cited by 28 publications

References 4 publications

Systematic re-evaluation of intraoperative motor-evoked potential suppression in scoliosis surgery

Systematic re-evaluation of intraoperative motor-evoked potential suppression in scoliosis surgery

The influence of depth of anesthesia on motor evoked potential response during awake craniotomy

Influence of propofol concentrations on multipulse transcranial motor evoked potentials

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