Abstract:
BACKGROUND:We compared the effect of propofol and sevoflurane combined with remifentanil under comparable bispectral index (BIS) levels on transcranial electric motor-evoked potentials (TceMEPs) and somatosensory-evoked potentials (SSEPs) during brainstem surgery. MATERIALS AND METHODS:A total of 40 consecutive patients (20 per group) undergoing brainstem surgery were randomly assigned to 2 groups receiving either 0.5 MAC sevoflurane or propofol at an effect-site concentration of 2.5 µg/mL for maintenance of anesthesia. Remifentanil was administered to both groups at a rate of 0.25 to 0.35 μg/kg/min along with cisatracurium (0.03 to 0.04 mg/kg/h). TceMEP recordings were carried out in the abductor pollicis brevis, abductor hallucis, and tibialis anterior muscles, whereas cortical SSEPs were measured with posterior tibial nerve stimulation. Amplitudes and latencies of TceMEPs and SSEPs were recorded at 1, 2, 3, and 4 hours after the induction of anesthesia. RESULTS:BIS values remained in the 45 to 60 range. Amplitudes of TceMEPs were significantly higher in the propofol group than those in the sevoflurane group (P<0.05, at all study time points in abductor pollicis brevis and abductor hallucis muscles and only 4 h after anesthetic induction for tibialis anterior muscle), whereas latencies were shorter in the propofol group than those in the sevoflurane group (P<0.05). No differences were observed in latency and amplitude while recording SSEPs between the 2 anesthetic techniques. None of the patients had TceMEPs and SSEPs amplitude or latency changes, exceeding our set limit. CONCLUSIONS:Both sevoflurane and propofol at low dosages combined with remifentanil under comparable BIS values and partial muscle relaxation can be used when monitoring of TceMEPs and SSEPs is required for brainstem surgery.
journal_name
J Neurosurg Anesthesioljournal_title
Journal of neurosurgical anesthesiologyauthors
Hernández-Palazón J,Izura V,Fuentes-García D,Piqueras-Pérez C,Doménech-Asensi P,Falcón-Araña Ldoi
10.1097/ANA.0000000000000157subject
Has Abstractpub_date
2015-10-01 00:00:00pages
282-8issue
4eissn
0898-4921issn
1537-1921journal_volume
27pub_type
杂志文章,随机对照试验abstract:BACKGROUND:In patients with severe brain injury, endotracheal suctioning (ETS) can increase intracranial pressure (ICP) and reduce cerebral perfusion pressure (CPP). The aim of this prospective, blinded clinical trial was to assess the effectiveness of aerosolized lidocaine to prevent increase of ICP induced by ETS in ...
journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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doi:10.1097/00008506-199601000-00008
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 临床试验,杂志文章
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更新日期:2004-10-01 00:00:00
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章
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journal_title:Journal of neurosurgical anesthesiology
pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of neurosurgical anesthesiology
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journal_title:Journal of neurosurgical anesthesiology
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