title: Total i.v. anaesthesia for transcranial magnetic evoked potential spinal cord monitoring.
abstract: Continuous intraoperative monitoring of transcranial magnetic motor evoked potentials (TcMMEP) can warn the surgeon of motor tract damage more effectively than somatosensory evoked potentials. As a non-invasive technique it is especially useful during post-traumatic internal fixation and is applicable whatever the level of the spinal cord at risk. Inhalation and many i.v. anaesthetics block the single pulse TcMMEP but a total i.v. anaesthetic regimen based on methohexitone, alfentanil and ketamine was effective in seven patients undergoing post-traumatic internal fixation. Consistent TcMMEP of 100-1000 mcV were obtained in all patients, with a latency change of only 2 ms above preoperative values. Good cardiovascular stability was maintained during operation.
authors.affiliation: Spinal Injuries Unit, Southport and Formby NHS Trust Hospital, Merseyside.
authors.forename: J W
authors.initials: JW
authors.lastname: Watt
authors.forename: M H
authors.initials: MH
authors.lastname: Fraser
authors.forename: B M
authors.initials: BM
authors.lastname: Soni
authors.forename: P K
authors.initials: PK
authors.lastname: Sett
authors.forename: R
authors.initials: R
authors.lastname: Clay
mesh_terms: D000328:Adult; D015760:Alfentanil; D000771:Anesthesia, Intravenous; D000778:Anesthetics, Dissociative; D018685:Anesthetics, Inhalation; D019054:Evoked Potentials, Motor; D005593:Fracture Fixation, Internal; D006801:Humans; D007649:Ketamine; D015225:Magnetoencephalography; D008723:Methohexital; D016343:Monitoring, Intraoperative; D013119:Spinal Cord Injuries / Q000601:surgery*
chemical_list: D000778:Anesthetics, Dissociative; D018685:Anesthetics, Inhalation; D015760:Alfentanil; D007649:Ketamine; D008723:Methohexital