Evaluation of Reliability of Post-Tetanic Motor-Evoked Potential Monitoring During Spinal Surgery Under General Anesthesia

• DOI: 10.1097/brs.0b013e318188adfc
• Publication Date: 2008-12-09T08:13:40Z
• Authors: Hironobu Hayashi; Masahiko Kawaguchi; Yuri Yamamoto; Satoki Inoue; Munehisa Koizumi; Yurito Ueda; Yoshinori Takakura; Hitoshi Furuya
• Keywords: Evoked potential; Tetanic stimulation; Tibialis anterior muscle; Tibial nerve

In Brief Study Design. A prospective research. Objective. Compare the reliability of post-tetanic motor-evoked potential (p-MEP) monitoring in detection motor injury during spinal surgery with that conventional MEP (c-MEP). Summary Background Data. Myogenic MEPs are sensitive to suppression by anesthetics and neuromuscular blockade. Recently, we reported a new technique for recording, called “p-MEP” which amplitude can be enlarged tetanic stimulation peripheral nerve before transcranial comparison c-MEP. The purpose this study is compare p-MEP Methods. Eighty patients undergoing elective were enrolled study. Both c-MEP performed throughout operation each patient. For recording c-MEPs, electrical train five pulses an interstimulus interval 2 milliseconds was compound muscle action potentials bilaterally recorded from abductor pollicis brevis, hallucis, tibialis anterior, soleus muscles. p-MEPs, (50 Hz, 50 mA, 5 sec) applied left median bilateral tibial nerves 1 second same false positive, negative, accuracy change function compared between Results. At baseline, success rates baseline 66.3% (53/80) 92.5% (74/80), respectively. 0%, 100%, respectively, whereas 4%, 20%, 95%, Conclusion. results indicate more reliable method detect changes under general anesthesia Application (p-MEPs) augment amplitudes anesthesia. indicated had higher less false-positive false-negative those MEP.