title: Selective neuromuscular blockade for intraoperative electrocorticography.
abstract: Local anesthesia is advocated for cortical mapping in certain neurological procedures. Occasionally, however, a modified general anesthetic is necessary. We describe a technique of balanced anesthesia in which the arm opposite to the craniotomy is selectively isolated from the effect of the neuromuscular blocking agent and hence preserves its motor response to cortical stimulation. The technique secures complete immobility of the patient during mapping of the brain, shortens the stimulation time, facilitates the localization of the motor cortex, precludes the development of full-blown seizures, increases safety and is well tolerated.
authors.affiliation: Department of Neuroanesthesia, Montreal Neurological Institute, Que., Canada.
authors.forename: M
authors.initials: M
authors.lastname: Abou-Madi
authors.forename: D
authors.initials: D
authors.lastname: Trop
authors.forename: S
authors.initials: S
authors.lastname: Lenis
authors.forename: A
authors.initials: A
authors.lastname: Olivier
authors.forename: R
authors.initials: R
authors.lastname: Leblanc
mesh_terms: D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General; D001279:Atracurium; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period
chemical_list: D001279:Atracurium