The influence of depth of anesthesia and blood pressure on muscle recorded motor evoked potentials in spinal surgery. A prospective observational study protocol.
Blood pressure
Depth of anesthesia
Intraoperative neurophysiological monitoring
Motor evoked potentials
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
17
03
2020
accepted:
30
12
2020
pubmed:
29
1
2021
medline:
18
11
2021
entrez:
28
1
2021
Statut:
ppublish
Résumé
For high-risk spinal surgeries, intraoperative neurophysiological monitoring (IONM) is used to detect and prevent intraoperative neurological injury. The motor tracts are monitored by recording and analyzing muscle transcranial electrical stimulation motor evoked potentials (mTc-MEPs). A mTc-MEP amplitude decrease of 50-80% is the most common warning criterion for possible neurological injury. However, these warning criteria often result in false positive warnings. False positives may be caused by inadequate depth of anesthesia and blood pressure on mTc-MEP amplitudes. The aim of this paper is to validate the study protocol in which the goal is to investigate the effects of depth of anesthesia (part 1) and blood pressure (part 2) on mTc-MEPs. Per part, 25 patients will be included. In order to investigate the effects of depth of anesthesia, a processed electroencephalogram (pEEG) monitor will be used. At pEEG values of 30, 40 and 50, mTc-MEP measurements will be performed. To examine the effect of blood pressure on mTc-MEPs the mean arterial pressure will be elevated from 60 to 100 mmHg during which mTc-MEP measurements will be performed. We hypothesize that by understanding the effects of depth of anesthesia and blood pressure on mTc-MEPs, the mTc-MEP monitoring can be interpreted more reliably. This may contribute to fewer false positive warnings. By performing this study after induction and prior to incision, this protocol provides a unique opportunity to study the effects of depths of anesthesia and blood pressure on mTc-MEPs alone with as little confounders as possible. Trial registration number NL7772.
Identifiants
pubmed: 33507473
doi: 10.1007/s10877-020-00645-1
pii: 10.1007/s10877-020-00645-1
pmc: PMC8497310
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
967-977Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. The Author(s).
Références
Curr Opin Anaesthesiol. 2018 Oct;31(5):532-538
pubmed: 30020157
Electroencephalogr Clin Neurophysiol. 1989 Jul-Aug;74(4):241-59
pubmed: 2471626
Clin Neurophysiol. 2008 Feb;119(2):248-64
pubmed: 18053764
Anesthesiology. 2009 Apr;110(4):759-65
pubmed: 19322941
Spine (Phila Pa 1976). 2018 Jul 1;43(13):890-894
pubmed: 29049087
J Clin Neurophysiol. 2017 Jan;34(1):22-31
pubmed: 28045854
Childs Nerv Syst. 2017 Nov;33(11):1985-1995
pubmed: 28676974
Spine (Phila Pa 1976). 2004 Jun 15;29(12):E258-65
pubmed: 15187651
Spine (Phila Pa 1976). 2010 Apr 20;35(9 Suppl):S37-46
pubmed: 20407350
Br J Anaesth. 2011 Jul;107(1):38-47
pubmed: 21624964
Anaesthesia. 2019 Feb;74(2):211-224
pubmed: 30378102
Clin Pharmacokinet. 2018 Dec;57(12):1539-1558
pubmed: 30019172
Neurosurgery. 2006 Jun;58(6):1129-43; discussion 1129-43
pubmed: 16723892
Anesthesiology. 1997 Jan;86(1):10-23
pubmed: 9009935
Int Anesthesiol Clin. 2015 Winter;53(1):53-73
pubmed: 25551742
Clin Neurophysiol. 2013 Dec;124(12):2291-316
pubmed: 24055297
Best Pract Res Clin Anaesthesiol. 2013 Jun;27(2):235-47
pubmed: 24012235
J Clin Oncol. 1986 Oct;4(10):1529-41
pubmed: 3760920
J Clin Neurophysiol. 2002 Oct;19(5):430-43
pubmed: 12477988
J Clin Monit Comput. 2006 Oct;20(5):347-77
pubmed: 16832580
Clin Neurophysiol. 2015 Sep;126(9):1825-32
pubmed: 25541524
Anesth Analg. 2014 Aug;119(2):288-301
pubmed: 24892803
Anesth Analg. 2020 Oct;131(4):1184-1192
pubmed: 32925339
Br J Anaesth. 2017 Jan;118(1):105-111
pubmed: 28039248
Acta Neurol Scand. 1990 Sep;82(3):183-90
pubmed: 2270746
Spine (Phila Pa 1976). 2018 Aug;43(16):1154-1160
pubmed: 30063222
Anesth Analg. 2019 Feb;128(2):265-277
pubmed: 29369096
Am J Electroneurodiagnostic Technol. 2005 Dec;45(4):225-39
pubmed: 16457049
Turk Neurosurg. 2018;28(3):341-348
pubmed: 28758184
Cochrane Database Syst Rev. 2011 Jan 19;(1):MR000031
pubmed: 21249714
J Clin Neurophysiol. 2017 Jan;34(1):4-11
pubmed: 28045852
Spine (Phila Pa 1976). 1992 May;17(5):498-503
pubmed: 1621147
Eur Spine J. 2014 Nov;23(11):2279-90
pubmed: 24898311
J Clin Monit Comput. 2018 Jun;32(3):541-548
pubmed: 28856576
Clin Neurophysiol Pract. 2016 Sep 16;1:54-57
pubmed: 30214960
Br J Anaesth. 2003 Oct;91(4):493-7
pubmed: 14504148
Neurophysiol Clin. 2007 Dec;37(6):431-9
pubmed: 18083499
Anesthesiology. 1997 Jan;86(1):24-33
pubmed: 9009936
Neurosurgery. 1989 Feb;24(2):246-52
pubmed: 2918975
JAMA. 2004 May 26;291(20):2457-65
pubmed: 15161896
Anesthesiology. 2013 Nov;119(5):1109-19
pubmed: 23770600
Best Pract Res Clin Anaesthesiol. 2006 Mar;20(1):81-99
pubmed: 16634416