Improvement of intraoperative somatosensory evoked potentials by ketamine.
Many anaesthetics effect the latency and amplitude of somatosensory evoked potentials (SSEP). We present a patient who underwent two anterior/posterior spine fusions (A/PSF) at age 11 and 12 years old after resection of a spinal astrocytoma. She did have residual neurologic deficits of her lower extremities. SSEPs were unobtainable during the first surgery using an opioid-based anaesthetic. A ketamine-based anaesthetic was used for the second surgery and SSEPs were easily monitored. No other factors seem to have changed between the two surgeries. The anaesthetic management during each procedure is reviewed and the contributions of other factors to SSEP monitoring discussed.
Agarwal
R
R
Department of Anesthesiology, Children's Hospital, Denver, Colorado 80218, USA.
Roitman
K J
KJ
Stokes
M
M
D000778:Anesthetics, Dissociative / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D001254:Astrocytoma / Q000601:surgery; D002648:Child; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005267:Femoral Nerve / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage*; D007866:Leg; D008874:Midazolam / Q000008:administration & dosage; D016343:Monitoring, Intraoperative; D018908:Muscle Weakness / Q000209:etiology; D010291:Paresis / Q000209:etiology; D011930:Reaction Time / Q000187:drug effects; D013120:Spinal Cord Neoplasms / Q000601:surgery; D013123:Spinal Fusion; D017409:Sufentanil / Q000008:administration & dosage; D013979:Tibial Nerve / Q000187:drug effects / Q000502:physiology; D014459:Ulnar Nerve / Q000187:drug effects / Q000502:physiology
D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D007649:Ketamine; D017409:Sufentanil; D008874:Midazolam