title: Neurophysiological monitoring under anesthesia to position a child with extreme lumbar spine flexion for MRI and CT scan.
abstract: A novel application of neurophysiological monitoring enabled us safely to anesthetize and position a child with severe lumbosacral spine flexion for diagnostic MRI and CT scan. We conducted a propofol-based anesthetic to optimize somatosensory (SSEP) and transcranial electric motor (tceMEP) evoked potential amplitudes, thereby facilitating dynamic neurological monitoring while fully extending the patient supine. In cases outside the operating room involving extraordinary changes in patient position, anesthesia providers may consider utilizing neurophysiological monitoring.
authors.affiliation: Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Sai
authors.initials: S
authors.lastname: Gundlapalli
authors.forename: Rahul S
authors.initials: RS
authors.lastname: Anand
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Schwartz
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Wierzbowski
authors.forename: David E
authors.initials: DE
authors.lastname: Cohen
authors.forename: Scott D
authors.initials: SD
authors.lastname: Cook-Sather
mesh_terms: D000293:Adolescent; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D003291:Conversion Disorder / Q000150:complications; D004558:Electric Stimulation / Q000379:methods; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D009068:Movement; D009482:Neurophysiology / Q000379:methods; D015742:Propofol / Q000008:administration & dosage; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016683:Supine Position; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol