[Effect of bolus propofol administration on muscle evoked potential (MsEP) during spine surgery].
Intraoperative monitoring of descending pathways by means of muscle evoked potential (MsEP) is a reliable method to monitor spinal cord motor function, but MsEP is readily affected by anesthetics. We monitored MsEP evoked by repetitive transcranial electrical stimulation of the motor cortex in 30 patients receiving spine surgery. Total intravenous anesthesia was maintained with propofol and fentanyl without any muscle relaxant. Onset latencies and peak to peak amplitudes of MsEP were evaluated before and after the bolus propofol administration. The concentrations of propofol in blood and the effect-site during MsEP monitoring were predicted by computer simulation software. The amplitude of MsEP decreased slightly by bolus propofol administration, but the latencies showed no significant change with propofol under the same condition. We consider that total intravenous anesthesia with propofol and fentanyl without muscle relaxants is compatible with the recording of MsEP evoked by high frequency repetitive electrical transcranial stimulations. When MsEP is monitored during spine surgery, anesthetic condition should be controlled carefully in order to maintain a stable blood concentration of propofol and thus to assure the reliability of MsEP measurements.
Kajiyama
S
S
Department of Anesthesia and Intensive Care, Hiroshima City Asa Hospital, Hiroshima 731-0293.
Sanuki
M
M
Kinoshita
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D018686:Anesthetics, Intravenous / Q000008:administration & dosage* / Q000097:blood; D002648:Child; D019054:Evoked Potentials, Motor; D005260:Female; D005283:Fentanyl; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009132:Muscles / Q000502:physiology*; D015742:Propofol / Q000008:administration & dosage* / Q000097:blood; D013116:Spinal Cord / Q000502:physiology / Q000601:surgery*; D013131:Spine / Q000601:surgery*
D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol