title: Improving successful rate of transcranial electrical motor-evoked potentials monitoring during spinal surgery in young children.
abstract: BACKGROUND
  This prospective study was to investigate the successful rate of intraoperative motor evoked potentials (MEP) monitoring for children (<12 years old) with congenital scoliosis.
  
  
  METHODS
  A consecutive series of 27 young children (7 girls and 20 boys; from 1 to 11 years old) between September 2007 and November 2009, were enrolled to this study. 12 patients received general anesthesia based on TIVA, induced with propofol 2-4 mg/kg and fentanyl 3-5 µg/kg followed by a continuous infusion of propofol (20-150 µg/kg/min, at mean of 71.7 µg/kg/min). The other 15 patients received combined inhalation and intravenous anesthesia, induced with sevoflurane and fentanyl 3-5 µg/kg and maintained by sevoflurane (0.5-1%). The maintenance of anaesthesia management was performed with stable physiological parameters during surgery.
  
  
  RESULTS
  Intraoperative MEP monitoring was successfully performed in all patients, while SEP was successfully performed in 26 of 27 patients. There was no significant difference of successful rates between SEP and MEP monitoring (P > 0.05). As well, no difference in MEP successful rates was observed in two groups with different anesthetic techniques. No wake-up test and no post-operative neurological deficits occurred in this series of patients.
  
  
  CONCLUSIONS
  Low dose anesthesia by either TIVA with propofol or sevoflurane-based mixture anesthesia protocol can help the intraoperative spinal cord monitoring to successfully elicit MEP and perform reliable monitoring for patients below 12 years of age.
authors.affiliation: Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Junlin
authors.initials: J
authors.lastname: Yang
authors.forename: Zifang
authors.initials: Z
authors.lastname: Huang
authors.forename: Haihua
authors.initials: H
authors.lastname: Shu
authors.forename: Yuguang
authors.initials: Y
authors.lastname: Chen
authors.forename: Xinrui
authors.initials: X
authors.lastname: Sun
authors.forename: Weifeng
authors.initials: W
authors.lastname: Liu
authors.forename: Yunling
authors.initials: Y
authors.lastname: Dou
authors.forename: Chaofan
authors.initials: C
authors.lastname: Xie
authors.forename: Xiang
authors.initials: X
authors.lastname: Lin
authors.forename: Yong
authors.initials: Y
authors.lastname: Hu
mesh_terms: D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology*; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology; D008991:Monitoring, Physiologic / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods*; D019637:Orthopedic Procedures / Q000379:methods*; D015742:Propofol / Q000494:pharmacology; D011446:Prospective Studies; D012189:Retrospective Studies; D012600:Scoliosis / Q000151:congenital / Q000503:physiopathology / Q000601:surgery*; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D000077149:Sevoflurane; D015742:Propofol