The effect of ketamine anesthetic induction on muscle responses to transcranial magnetic cortex stimulation studied in man.

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 Lett

journal_title

Neuroscience letters

authors

Kothbauer K,Schmid UD,Liechti S,Rösler KM

doi

10.1016/0304-3940(93)90182-k

subject

Has Abstract

pub_date

1993-05-14 00:00:00

pages

105-8

issue

1-2

eissn

0304-3940

issn

1872-7972

pii

0304-3940(93)90182-K

journal_volume

154

pub_type

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