Abstract:
:In man, an anesthetic agent that induces surgical anesthesia with minimal influence on descending pyramidal tract activity remains to be found. Anesthesia with ketamine allows recording of stable compound muscle action potentials (CMAPs) to single transcranial magnetic stimulations of the motor cortex (CortStim) in monkeys. This report describes the findings in 5 patients, where CMAPs to CortStim were recorded from the right hypothenar during anesthesia induction with ketamine. The agent was injected intravenously every 90 s in 6 steps of 0.5 mg up to a maximum of 3 mg/kg body weight (BW). Surgical anesthesia was achieved after ketamine injection of 1.5 (n = 4 patients) or 2.0 mg/kg BW (n = 1). In the five individuals tested, CMAP amplitudes and latencies (mean; range) were 2.6 (1.6-5.8) mV and 22.8 (20.4-24.6) ms before induction, and 1.6 (0.3-4.7) mV and 23.5 (21.7-24.5) ms after administration of the maximum dose. The paired differences (mean +/- 1 S.D.) were 0.8 +/- 0.6 mV and 1.0 +/- 0.8 ms and were statistically not significant (n = 5, P = 0.1, Wilcoxon-test). With ketamine as a single anesthetic induction agent CMAPs to single CortStim remain easily recordable even in dosages higher than those necessary to induce surgical anesthesia. All other previously tested anesthetic agents suppress CMAPs to CortStim as soon as the patient is unconscious.
journal_name
Neurosci Lettjournal_title
Neuroscience lettersauthors
Kothbauer K,Schmid UD,Liechti S,Rösler KMdoi
10.1016/0304-3940(93)90182-ksubject
Has Abstractpub_date
1993-05-14 00:00:00pages
105-8issue
1-2eissn
0304-3940issn
1872-7972pii
0304-3940(93)90182-Kjournal_volume
154pub_type
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