Monitoring of intraoperative motor-evoked potentials under conditions of controlled neuromuscular blockade. Academic Article uri icon

Overview

abstract

  • Motor-evoked potentials were recorded after electrical spinal cord stimulation in 19 patients undergoing neurosurgical or orthopedic procedures. Anesthesia was maintained with nitrous oxide, opioids, and inhaled anesthetics. Vecuronium was infused sufficient to eliminate 90% of twitch tension. The spinal cord was stimulated using either epidural or subarachnoid electrodes. Compound muscle action potentials were recorded from quadriceps and tibialis anterior muscles. Well-formed, stable motor-evoked potentials were recorded in all but one patient, in whom a preexisting myelopathy was felt to preclude recording. Intraoperative deterioration of motor-evoked potentials occurred in one patient who had a postoperative neurologic deficit. This study demonstrates the feasibility and utility of intraoperative motor tract monitoring using direct spinal cord stimulation. Controlled neuromuscular blockade permits recording of compound muscle action potentials while eliminating patient motor activity that could interfere with surgery.

publication date

  • November 1, 1993

Research

keywords

  • Electromyography
  • Monitoring, Intraoperative
  • Neuromuscular Junction
  • Spinal Cord

Identity

Scopus Document Identifier

  • 0027453899

Digital Object Identifier (DOI)

  • 10.1213/00000539-199311000-00007

PubMed ID

  • 8214726

Additional Document Info

volume

  • 77

issue

  • 5