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Evoked potential and anesthesia

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https://www.readbyqxmd.com/read/28966818/intraoperative-monitoring-for-spinal-radiculomedullary-artery-aneurysm-occlusion-treatment-what-when-and-how-long
#1
Federico Landriel, Matteo Baccanelli, Santiago Hem, Eduardo Vecchi, Mariana Bendersky, Claudio Yampolsky
BACKGROUND: Spinal radiculomedullary artery aneurysms are extremely rare. Treatment should be tailored to clinical presentation, distal aneurysm flow, and lesion anatomical features. When a surgical occlusion is planned, it is necessary to evaluate whether intraoperative monitoring (IOM) should be considered as an indispensable tool to prevent potential spinal cord ischemia. METHODS: We present a patient with symptoms and signs of spinal subarachnoid hemorrhage resulting from the rupture of a T4 anterior radiculomedullary aneurysm who underwent open surgical treatment under motor evoked potential (MEP) monitoring...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28965444/intraoperative-neuromonitoring-alerts-in-a-pediatric-deformity-center
#2
Maria Zuccaro, James Zuccaro, Amer F Samdani, Joshua M Pahys, Steven W Hwang
OBJECTIVE Intraoperative neuromonitoring (IONM) involves the use of somatosensory evoked potentials (SSEPs) and transcranial electric motor evoked potentials (TceMEPs). In this retrospective study the authors examined the sensitivity and specificity of both SSEPs and TceMEPs during pediatric spinal deformity surgeries. METHODS The authors performed a retrospective quantitative analysis of data obtained in 806 patients (197 males and 609 females) treated from December 2011 until October 2015. All patients were diagnosed with scoliosis that was classified as one of the following: adolescent idiopathic scoliosis (AIS) (38%), congenital scoliosis (22%), or syndromic scoliosis (40%)...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28922235/perioperative-inflammation-and-its-modulation-by-anesthetics
#3
Jan Rossaint, Alexander Zarbock
Surgery and other invasive procedures, which are routinely performed during general anesthesia, may induce an inflammatory response in the patient. This inflammatory response is an inherent answer of the body to the intervention and can be both beneficial and potentially harmful. The immune system represents a unique evolutionary achievement equipping higher organisms with an effective defense mechanism against exogenous pathogens. However, not only bacteria might evoke an immune response but also other noninfectious stimuli like the surgical trauma or mechanical ventilation may induce an inflammatory response of varying degree...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28899835/successful-treatment-by-microvascular-decompression-surgery-of-a-patient-with-hemiparesis-due-to-vertebral-artery-compression-of-the-medulla-oblongata-a-case-report-and-literature-review
#4
Jibin Ren, Hongtao Sun, Yunfeng Diao, Xuegang Niu, Hang Wang, Zhengjun Wei, Fei Yuan
Little literature is available on hemiparesis caused by vascular medullary compression, which may occur as a result of dolichoectasia of the vertebrobasilar arterial system. In this paper, we report a case of vertebral artery compression of the medulla oblongata in a 67-year old woman. The patient was hypertensive and developed hemiparesis and intermittent spasms for five years, which became worsened for one year. Cranial nerve MRI showed compression of the medulla oblongata by the left vertebral artery. Motor evoked potential (MEP) examination showed abnormal conduction of MEPs of bilateral toe abductors...
September 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28856576/changes-in-transcranial-motor-evoked-potentials-during-hemorrhage-are-associated-with-increased-serum-propofol-concentrations
#5
Jeremy A Lieberman, John Feiner, Mark Rollins, Russ Lyon
Transcranial motor evoked potentials (TcMEPs) monitor the integrity of the spinal cord during spine surgery. Propofol-based anesthesia is favored in order to enhance TcMEP quality. During intraoperative hemorrhage, TcMEP amplitudes may be reduced. The serum concentration of propofol may increase during hemorrhage. No study has determined whether changes in TcMEPs due to hemorrhage are related to changes in propofol blood levels. We monitored TcMEPs, mean arterial pressure (MAP), and cardiac output (CO) and hemoglobin in pigs (n = 6) undergoing controlled progressive hemorrhage during a standardized anesthetic with infusions of propofol, ketamine, and fentanyl...
August 30, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28840256/-neurophysiological-monitoring-during-surgical-procedures
#6
REVIEW
P Michels, A Bräuer, M Bauer, M Söhle
The application of intraoperative neurophysiological monitoring (IONM) is gaining more and more importance in daily clinical practice. The use of IONM allows the localization of neural structures and to control functioning of the peripheral and central nervous systems in anesthetized patients. This enables surgeons to identify and to protect neural structures and cerebral areas. The use of IONM also enables anesthesiologists to adjust anesthesia and cardiopulmonary therapy to the individual needs of the patient...
August 24, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28837906/comparison-of-visual-evoked-potential-monitoring-during-spine-surgeries-under-total-intravenous-anesthesia-versus-balanced-general-anesthesia
#7
RANDOMIZED CONTROLLED TRIAL
Alberto A Uribe, Ehud Mendel, Zoe A Peters, Bassel F Shneker, Mahmoud Abdel-Rasoul, Sergio D Bergese
OBJECTIVE: To determine the comparison of its clinical utility and safety profile for visual evoked potential (VEP) monitoring during prone spine surgeries under total intravenous anesthesia (TIVA) versus balanced general anesthesia using the SightSaver™ visual stimulator. METHODS: The protocol was designed asa pilot, single center, prospective, randomized, and double-arm study. Subjects were randomized to receive either TIVA or balanced general anesthesia. Following induction and intubation, 8 electrodes were placed subcutaneously to collect VEP recordings...
October 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#8
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#9
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28733205/-dehydrofukinone-modulates-membrane-potential-and-delays-seizure-onset-by-gabaa-receptor-mediated-mechanism-in-mice
#10
Quelen Iane Garlet, Luana da Costa Pires, Laura Hautrive Milanesi, Joseane Righes Marafiga, Bernardo Baldisserotto, Carlos Fernando Mello, Berta Maria Heinzmann
(+)-Dehydrofukinone (DHF), isolated from Nectandra grandiflora (Lauraceae) essential oil, induces sedation and anesthesia by modulation of GABAa receptors. However, no study has addressed whether DHF modulates other cellular events involved in the control of cellular excitability, such as seizure behavior. Therefore, the aim of the present study was to investigate the effect of DHF on cellular excitability and seizure behavior in mice. For this purpose, we used isolated nerve terminals (synaptosomes) to examine the effect of DHF on the plasma membrane potential, the involvement of GABAa receptors and the downstream activation of Ca(2+) mobilization...
October 1, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28724492/evaluation-of-pain-assessment-techniques-and-analgesia-efficacy-in-a-female-guinea-pig-cavia-porcellus-model-of-surgical-pain
#11
Vanessa L Oliver, Stephanie Athavale, Katherine E Simon, Lon V Kendall, Jean A Nemzek, Jennifer L Lofgren
Guinea pigs (Cavia porcellus) are a frequently used species in research, often involving potentially painful procedures. Therefore, evidence-based recommendations regarding analgesia are critically needed to optimize their wellbeing. Our laboratory examined the efficacy of carprofen and extended-release (ER) buprenorphine, alone and as a multimodal combination, for relieving postsurgical pain in guinea pigs. Animals were assessed by using evoked (mechanical hypersensitivity), nonevoked (video ethogram, cageside ethogram, time-to-consumption test), and clinical (weight loss) measurements for 96 h during baseline, anesthesia-analgesia, and hysterectomy conditions...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28666848/a-randomized-cross-over-study-of-the-effects-of-lidocaine-on-motor-and-sensory-evoked-potentials-during-spinal-surgery
#12
Michael K Urban, Kara Fields, Sean W Donegan, Jonathan C Beathe, David W Pinter, Oheneba Boachie-Adjei, Ronald G Emerson
BACKGROUND CONTEXT: Lidocaine has emerged as a useful adjuvant anesthetic agent for cases requiring intraoperative monitoring of motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs). A previous retrospective study suggested that lidocaine could be used as a component of propofol-based intravenous anesthesia without adversely affecting MEP or SSEP monitoring, but did not address the effect of addition of lidocaine on the MEP and SSEP signals of individual patients...
June 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28621258/evaluation-of-pain-assessment-techniques-and-analgesia-efficacy-in-a-female-guinea-pig-cavia-porcellus-model-of-surgical-pain
#13
Vanessa L Oliver, Stephanie Athavale, Katherine E Simon, Lon V Kendall, Jean A Nemzek, Jennifer L Lofgren
Guinea pigs (Cavia porcellus) are a frequently used species in research, often involving potentially painful procedures.Therefore, evidence-based recommendations regarding analgesia are critically needed to optimize their wellbeing. Ourlaboratory examined the efficacy of carprofen and extended-release (ER) buprenorphine, alone and as a multimodal combination,for relieving postsurgical pain in guinea pigs. Animals were assessed by using evoked (mechanical hypersensitivity),nonevoked (video ethogram, cageside ethogram, time-to-consumption test), and clinical (weight loss) measurements for 96 h during baseline, anesthesia-analgesia, and hysterectomy conditions...
June 15, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28606109/neurophysiological-assessment-of-spinal-cord-injuries-in-dogs-using-somatosensory-and-motor-evoked-potentials
#14
REVIEW
Maria Claudia Campos Mello Inglez de Souza, Ricardo José Rodriguez Ferreira, Geni Cristina Fonseca Patricio, Julia Maria Matera
Somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) are non-invasive neurophysiological tests that reflect the functional integrity of sensory and motor pathways. Despite their extensive use and description in human medicine, reports in veterinary medicine are scarce. SSEPs are obtained via peripheral stimulation of sensory or mixed nerves; stimulation induces spinal and cortical responses, which are recorded when sensory pathways integrity is preserved. MEPs can be obtained via transcranial electrical or magnetic stimulation; in this case, thoracic and pelvic limb muscle responses are captured if motor pathways are preserved...
June 12, 2017: Acta Veterinaria Scandinavica
https://www.readbyqxmd.com/read/28604088/effect-of-topical-anesthesia-using-an-adhesive-patch-and-anesthetic-solution
#15
Toshiyuki Kishimoto, Nobuyuki Matsuura, Masataka Kasahara, Tatsuya Ichinohe
We analyzed trigeminal somatosensory evoked potentials (TSEP) to the alveolar mucosa to investigate the efficacy of an amide local anesthetic, 2% lidocaine hydrochloride with 12.5 μg/mL epinephrine (Lido treatment) as a topical anesthetic. Eighteen consenting healthy adult volunteers were enrolled. A volume of 0.06 mL of Lido, 0.06 g of 20% benzocaine, or 0.06 mL of physiological saline (control) was instilled onto a hemostatic adhesive patch, which was then applied to the alveolar mucosa at the maxillary right canine for 5 minutes...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28596267/adaptations-of-motoneuron-properties-after-weight-lifting-training-in-rats
#16
Piotr Krutki, Włodzimierz Mrówczyński, Marcin Bączyk, Dawid Łochyński, Jan Celichowski
Resistance training, with repeated short-term and high-intensity exercises, is responsible for an increase in muscle mass and force. The aim of this study was to determine whether such training induces adaptations in the electrophysiological properties of motoneurons innervating the trained muscles and to relate these adaptive changes to previous observations made on motor unit contractile properties. The study was performed on adult male Wistar rats. Animals from the training group were subjected to a five-week voluntary progressive weight-lifting program, while control rats were restricted to standard cage activity...
June 8, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28589067/intraoperative-dexmedetomidine-induced-polyuric-syndrome
#17
Shannon Granger, David Ninan
A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. The patient's urine output increased gradually during the nine-hour surgical procedure from 150 mL/hour to over 700 mL/hour in the eighth hour of the procedure, where it remained until the end of the procedure...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28494560/-visual-impact-of-sub-tenon-s-anesthesia-during-surgery-for-retinal-detachment
#18
W Q Chen, G H Zhang, H J Lin, H C Huang, D S Lin, J L Zheng, D Z Zheng
Objective: To investigate the visual impact and influence factors of sub-Tenon's anesthesia in retinal detachment patients during pars plana vitrectomy (PPV) or combined phacoemulsification and PPV surgery. Methods: In this prospective case series study, 104 consecutive patients who underwent PPV or combined phacoemulsification and PPV under sub-Tenon's anesthesia between October 2012 and December 2013 were enrolled. Intraoperatively, the patients were asked whether they could see the light of the operating microscope or not at 5 minutes after sub-Tenon's anesthesia, and at the end of phacoemulsification, core vitreous removal, peripheral vitreous removal and the whole surgery, with their contralateral eyes being covered tightly and no photobleaching...
May 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28485386/monitoring-rate-and-predictability-of-intraoperative-monitoring-in-patients-with-intradural-extramedullary-and-epidural-metastatic-spinal-tumors
#19
H Kang, H S Gwak, S H Shin, M K Woo, I H Jeong, H Yoo, J W Kwon, S H Lee
STUDY DESIGN: Single-center retrospective study. OBJECTIVES: To evaluate the monitoring rate, sensitivity and specificity of intraoperative monitoring (IOM) during removal of intradural extramedullary (IDEM) or epidural metastatic spinal tumors. Also, to assess the efficacy of monitoring somatosensory-evoked potentials (SSEP) when motor-evoked potentials (MEP) are not measurable. SETTING: The Neuro-Oncology Clinic, National Cancer Center, Korea...
October 2017: Spinal Cord
https://www.readbyqxmd.com/read/28368914/intraoperative-neurological-monitoring-with-evoked-potentials-during-carotid-endarterectomy-versus-cooperative-patients-under-general-anesthesia-technique-a-retrospective-study
#20
Valeria Marinò, Fulvio Aloj, Maria Vargas, Gianmario Spinelli, Francesco Pompeo, Luigi Chiacchiari, Giuseppe Servillo, Elio Franco
INTRODUCTION: The best technique to evaluate contralateral carotid flow during carotid endarterectomy (CEA) is still debated; an accurate detection of efficient contralateral blood flow can avoid unnecessary shunt placement and its complications. The aim of this retrospective observational study was to evaluate and compare the safety and efficacy of general anesthesia with motor-evoked potential and somatosensory-evoked potentials (mSSEP and tcMEP) versus cooperative patients under general anesthesia (CPGA) technique for CEA...
March 31, 2017: Journal of Neurosurgical Anesthesiology
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