title: Effects of Dexmedetomidine on motor- and somatosensory-evoked potentials in patients with thoracic spinal cord tumor: a randomized controlled trial.
abstract: We hypothesized that the addition of dexmedetomidine in a clinically relevant dose to propofol-remifentanil anesthesia regimen does not exert an adverse effect on motor-evoked potentials (MEP) and somatosensory-evoked potentials (SSEP) in adult patients undergoing thoracic spinal cord tumor resection.
  
  
  
  Seventy-one adult patients were randomized into three groups. Propofol group (n = 25): propofol-remifentanil regimenand the dosage was adjusted to maintain the bispectral index (BIS) between 40 and 50. DP adjusted group (n = 23): Dexmedetomidine (0.5 μg/kg loading dose infused over 10 min followed by a constant infusion of 0.5 μg/kg/h) was added to the propofol-remifentanil regimen and propofol was adjusted to maintain BIS between 40 and 50. DP unadjusted group (n = 23): Dexmedetomidine (administer as DP adjusted group) was added to the propofol-remifentanil regimen and propofol was not adjusted. All patients received MEP, SSEP and BIS monitoring.
  
  
  
  There were no significant changes in the amplitude and latency of MEP and SSEP among different groups (P > 0.05). The estimated propofol plasma concentration in DP adjusted group (2.7 ± 0.3 μg/ml) was significantly lower than in propofol group (3.1 ± 0.2 μg/ml) and DP unadjusted group (3.1 ± 0.2 μg/ml) (P = 0.000). BIS in DP unadjusted group (35 ± 5) was significantly lower than in propofol group (44 ± 3) (P = 0.000).
  
  
  
  The addition of dexmedetomidine to propofol-remifentanil regimen does not exert an adverse effect on MEP and SSEP monitoring in adult patients undergoing thoracic spinal cord tumor resection.
  
  
  
  The study was registered with the Chinese Clinical Trial Registry on January 31st, 2014. The reference number was ChiCTR-TRC-14004229.
authors.affiliation: Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, China, 100050.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Departments of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Lingzhong
authors.initials: L
authors.lastname: Meng
authors.affiliation: Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, China, 100050.
authors.forename: Yuming
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Neurophysiological Monitoring, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Qiao
authors.affiliation: Neurosurgery/Neurophysiological Monitoring Service, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Lanjun
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantan Xili, Dongcheng District, Beijing, China, 100050. ruquan.han@gmail.com.
authors.forename: Ruquan
authors.initials: R
authors.lastname: Han
authors.affiliation: Departments of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Adrian W
authors.initials: AW
authors.lastname: Gelb
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology; D056805:Consciousness Monitors; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects; D019054:Evoked Potentials, Motor / Q000187:drug effects*; D005073:Evoked Potentials, Somatosensory / Q000187:drug effects*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000008:administration & dosage; D015742:Propofol / Q000008:administration & dosage / Q000493:pharmacokinetics; D000077208:Remifentanil; D013120:Spinal Cord Neoplasms / Q000601:surgery*; D013904:Thoracic Vertebrae
chemical_list: D018686:Anesthetics, Intravenous; D006993:Hypnotics and Sedatives; D010880:Piperidines; D020927:Dexmedetomidine; D000077208:Remifentanil; D015742:Propofol
keywords: Dexmedetomidine; Motor-evoked potentials; RCT; Somatosensory-evoked potentials; Spinal cord tumor