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Journal of Clinical Monitoring and Computing

02-11-2023 | Motor Evoked Potential | Original Research

Utility of desflurane as an anesthetic in motor-evoked potentials in spine surgery and the facilitating effect in tetanic stimulation of bilateral median nerves

Authors: Sachiko Kawasaki, Hideki Shigematsu, Masato Tanaka, Masahiko Kawaguchi, Hironobu Hayashi, Tsunenori Takatani, Yuma Suga, Yusuke Yamamoto, Yasuhito Tanaka

Published in: Journal of Clinical Monitoring and Computing

Abstract

Although desflurane is a safe and controllable inhalation anesthetic used in spinal surgery, to our knowledge, there have been no reports of successful motor-evoked potential (MEP) recordings under general anesthesia with desflurane alone. A high desflurane concentration may reduce the risk of intraoperative awareness but can also reduce the success of MEP recording. Therefore, we aimed to evaluate the reliability of MEP monitoring and investigate whether tetanic stimulation can augment MEP amplitude under general anesthesia with high-concentration desflurane during spinal surgery. We prospectively evaluated 46 patients who were scheduled to undergo lumbar surgery at a single center between 2018 and 2020. Anesthesia was maintained with an end-tidal concentration of 4% desflurane and remifentanil. Compound muscle action potentials were recorded bilaterally from the abductor pollicis brevis, abductor hallucis, tibialis anterior, gastrocnemius, and quadriceps. For post-tetanic MEPs (p-MEPs), tetanic stimulation was applied to the median nerves (p-MEPm) and tibial nerves (p-MEPt) separately before transcranial stimulation. The average success rates for conventional MEP (c-MEP), p-MEPm, and p-MEPt were 77.9%, 80%, and 79.3%, respectively. The p-MEPm amplitudes were significantly higher than the c-MEP amplitudes in all muscles (P < 0.05), whereas the p-MEPt amplitudes were not significantly different from the c-MEP amplitudes. The MEP recording success rates for the gastrocnemius and quadriceps were inadequate. However, bilateral median nerve tetanic stimulation can effectively augment MEPs safely under general anesthesia with high-concentration desflurane in patients who undergo spinal surgery.

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Title: Utility of desflurane as an anesthetic in motor-evoked potentials in spine surgery and the facilitating effect in tetanic stimulation of bilateral median nerves
Authors: Sachiko Kawasaki
Hideki Shigematsu
Masato Tanaka
Masahiko Kawaguchi
Hironobu Hayashi
Tsunenori Takatani
Yuma Suga
Yusuke Yamamoto
Yasuhito Tanaka
Publication date: 02-11-2023
Publisher: Springer Netherlands
Keywords: Motor Evoked Potential
Motor Evoked Potential
General Anesthesia
Anesthetics
Desflurane
Inhalation Anesthetics
Inhalation Anesthetics
Propofol
Published in: Journal of Clinical Monitoring and Computing
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-023-01096-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Utility of desflurane as an anesthetic in motor-evoked potentials in spine surgery and the facilitating effect in tetanic stimulation of bilateral median nerves

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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