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Dexmedetomidine motor evoked potentials

Pedro Calderón, Paul Deltenre, Ida Stany, Jean-Paul Kaleeta Maalu, Magali Stevens, Jean Lamoureux, Michel Bellemans, Sylvie Dujardin, Philippe Van der Linden, Bernard Dachy
OBJECTIVE: To study the effect of clonidine administrated as a co-analgesic during scoliosis surgery, on the neuromonitoring of spinal motor pathways. METHODS: Using standardized intraoperative monitoring, we compared the time course of peripherally and transcranially electrically evoked motor potentials (TcEMEPs) before and after injection of a single bolus of clonidine in children under total intravenous anesthesia (TIVA). MEP data were obtained from 9 patients and somatosensory evoked potentials (SSEPs) were obtained from 2 patients...
April 2018: Neurophysiologie Clinique, Clinical Neurophysiology
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
H-L Amendt, J S Siedenburg, N Steffensen, F J Söbbeler, A Schütter, J Tünsmeyer, K Rohn, S B R Kästner, A Tipold, V M Stein
The aim of this study was to evaluate the influence of two sedation protocols on transcranial magnetic motor evoked potentials (TMMEPs) after transcranial magnetic stimulation in medium sized dogs. Onset latencies and peak-to-peak amplitudes, elicited in the extensor carpi radialis and cranial tibial muscles, were analysed in 10 healthy Beagles that received either acepromazine or dexmedetomidine in combination with levomethadone/fenpipramide, in a crossover design. Similar TMMEP recordings could be made using both sedation protocols at 80-90% stimulation intensity; however, there were significantly shorter onset latencies with the acepromazine-levomethadone/fenpipramide protocol at 100% stimulation intensity...
November 2016: Veterinary Journal
Yan Li, Lingzhong Meng, Yuming Peng, Hui Qiao, Lanjun Guo, Ruquan Han, Adrian W Gelb
BACKGROUND: 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. METHODS: 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...
August 2, 2016: BMC Anesthesiology
Irene Rozet, Julia Metzner, Marcia Brown, Miriam M Treggiari, Jefferson C Slimp, Greg Kinney, Deepak Sharma, Lorri A Lee, Monica S Vavilala
BACKGROUND: The effect of dexmedetomidine on evoked potentials (EPs) has not been elucidated. We aimed to investigate the effect of dexmedetomidine on somatosensory, motor, and visual EPs. METHODS: After IRB approval, 40 adult patients scheduled for elective spine surgery using total IV anesthesia with propofol and remifentanil were randomly assigned to receive either dexmedetomidine (n = 20) or placebo (n = 20) in a double-blind, placebo-controlled trial. After obtaining informed consent, positioning, and baseline EPs recording, patients were randomly assigned to either IV dexmedetomidine 0...
August 2015: Anesthesia and Analgesia
Wonjung Hwang, Jaemin Lee, Jihyun Park, Jin Joo
BACKGROUND: Total intravenous anesthesia (TIVA) is used widely in spinal surgery because inhalational anesthetics are known to decrease the amplitude of motor evoked potentials. Presently, dexmedetomidine is used as an adjuvant for propofol-based TIVA. We compared the effects of remifentanil and dexmedetomidine on pain intensity as well as the analgesic requirements after post-anesthesia care unit (PACU) discharge in patients undergoing spinal surgery. METHODS: Forty patients scheduled for posterior lumbar interbody fusion (PLIF) surgery under general anesthesia were enrolled...
2015: BMC Anesthesiology
Z Chen, S Lin, W Shao
OBJECTIVE: The aim of this study was to evaluate the effects of different doses of dexmedetomidine (Dex) compounded propofol and fentanyl on intraoperative somatosensory evoked potential (SEP) and motor evoked potential (MEP) monitoring on senile patients. METHODS: Forty-five patients undergoing elective spinal surgery were randomly divided into three groups: group C, group D1 (Dex, 0.3 μg kg(-1) h(-1)), and group D2 (Dex, 0.8 μg kg(-1) h(-1)). Anesthesia administration: midazolam, propofol, fentanyl, and cisatracurium...
December 2015: Irish Journal of Medical Science
Sheng Lin, Na Dai, Zhengyan Cheng, Wei Shao, Zhijian Fu
This aim of the present study was to evaluate the effects of dexmedetomidine (DEX) on the intraoperative monitoring of somatosensory-evoked potentials (SEPs) and motor-evoked potentials (MEPs) in patients undergoing spinal surgery. A total of 36 patients who received spinal surgery under general anesthesia were randomly divided into two groups (n=18 per group), group C, the test group and group D, the control group, and these groups were subjected to a matching anesthesia induction. In brief, the anesthesia was administered via injection of etomidate and fentanyl; once the patients were unconscious, a laryngeal mask airway (LMA) was inserted, SEPs and MEPs were monitored and the collected data were considered to be basic data...
May 2014: Experimental and Therapeutic Medicine
Jason S Nasse, Joseph B Travers
Regulation of feeding behavior involves the integration of multiple physiological and neurological pathways that control both nutrient-seeking and consummatory behaviors. The consummatory phase of ingestion includes stereotyped oromotor movements of the tongue and jaw that are controlled through brain stem pathways. These pathways encompass not only cranial nerve sensory and motor nuclei for processing feeding-related afferent signals and supplying the oromotor musculature but also reticular neurons for orchestrating ingestion and coordinating it with other behaviors that utilize the same musculature...
August 1, 2014: Journal of Neurophysiology
Osama A Ibraheim, Alsiddiky Abdulmonem, Jumana Baaj, Tariq Al Zahrani, Vincent Arlet
BACKGROUND: Surgical correction ofscoliosis carries significant blood loss and needs for blood transfusion with its inherent risks and cost. The aim of this double-blind, randomized, controlled study was to compare the effects of esmolol or dexmedetomidine on intraoperative blood loss, anesthetics consumption, intra operative hemodynamic and effects on spinal cord monitoring in patients undergoing scoliosis surgery. METHODS: After obtaining institute review board approval and written informed consent, 60 adolescents (ASA physical status I-II), 14-18-year of age scheduled for posterior spinal fusion scoliosis surgery were enrolled in the study...
February 2013: Middle East Journal of Anesthesiology
Rozanna Penney
Dexmedetomidine and ketamine infusions were the main anesthetic for a 15-year-old girl, who underwent scoliosis repair surgery with intraoperative wake-up test, somatosensory evoked potential (SSEP), and motor-evoked potential (MEP) monitoring. To achieve maintenance of anesthesia, dexmedetomidine and ketamine were administered concomitantly. The dexmedetomidine dose ranged from 0.9 to 1.2 microg/kg per hour throughout the case, and the ketamine dose ranged from 0.4 to 0.6 mg/kg per hour. The analgesic properties of dexmedetomidine and ketamine were complimented by the continuous fentanyl infusion at 1 to 2 microg/kg per hour...
December 2010: AANA Journal
Mohamed Mahmoud, Senthilkumar Sadhasivam, Shelia Salisbury, Todd G Nick, Beverly Schnell, Anthony K Sestokas, Cheryl Wiggins, Paul Samuels, Thomas Kabalin, John McAuliffe
BACKGROUND: Dexmedetomidine has been increasingly used as an adjunct to opioid-propofol total intravenous anesthesia (TIVA). The authors tested the hypothesis and found that clinically relevant blood levels of dexmedetomidine do not produce significant attenuation of the amplitude of transcranial electric motor-evoked potentials either independently or by interaction with propofol in a dose-dependent manner. METHODS: The authors planned to recruit 72 patients with idiopathic scoliosis who had posterior spine fusion surgery during propofol and remifentanil TIVA with dexmedetomidine as an adjunct...
June 2010: Anesthesiology
Endrit Bala, Daniel I Sessler, Dileep R Nair, Robert McLain, Jarrod E Dalton, Ehab Farag
BACKGROUND: Many commonly used anesthetic agents produce a dose-dependent amplitude reduction and latency prolongation of evoked responses, which may impair diagnosis of intraoperative spinal cord injury. Dexmedetomidine is increasingly used as an adjunct for general anesthesia. Therefore, the authors tested the hypothesis that dexmedetomidine does not have a clinically important effect on somatosensory and transcranial motor evoked responses. METHODS: Thirty-seven patients were enrolled and underwent spinal surgery with instrumentation during desflurane and remifentanil anesthesia with dexmedetomidine as an anesthetic adjunct...
September 2008: Anesthesiology
Joseph D Tobias, Timothy J Goble, Guy Bates, John T Anderson, Daniel G Hoernschemeyer
BACKGROUND: Dexmedetomidine may be a useful agent as an adjunct to an opioid-propofol total intravenous anesthesia (TIVA) technique during posterior spinal fusion (PSF) surgery. There are limited data regarding its effects on somatosensory (SSEPs) and motor evoked potentials (MEPs). METHODS: The data presented represent a retrospective review of prospectively collected quality assurance data. When the decision was made to incorporate dexmedetomidine into the anesthetic regimen for intraoperative care of patients undergoing PSF, a prospective evaluation of its effects on SSEPs and MEPs was undertaken...
November 2008: Paediatric Anaesthesia
David J Anschel, Andrew Aherne, Roy G Soto, Wesley Carrion, Carl Hoegerl, Palgun Nori, Peggy A Seidman
Intraoperative neurophysiological monitoring (IONM) during corrective spinal surgery is widely used. Because of the possible interference with the recording of evoked potentials by inhalational anesthetics, total intravenous anesthetic (TIVA) regimens have been advocated. TIVA regimens may be difficult to use in pediatric populations due to metabolic factors. We report on the results of multimodality IONM during 18 cases in which a TIVA regimen incorporating dexmedetomidine (Precedex, Hespira, Lake Forest, IL) was used...
February 2008: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Yuri Yamamoto, Masahiko Kawaguchi, Meiko Kakimoto, Satoki Inoue, Hitoshi Furuya
BACKGROUND: Dexmedetomidine is used in the perioperative management of patients, including as an intraoperative adjuvant. The effects of dexmedetomidine on myogenic motor evoked potentials (MEPs) remain undetermined. We conducted the present study to investigate the effects of dexmedetomidine on myogenic MEPs in rabbits. METHODS: New Zealand white rabbits were used for the studies. First, to determine appropriate doses of dexmedetomidine as an adjunct for anesthesia in rabbits, the level of anesthesia was evaluated by testing the palpebral and limb withdrawal reflexes, and the reactions to ear pinching and tail clamp at 5, 25, 50, 100 microg/kg/h...
June 2007: Anesthesia and Analgesia
Mohamed Mahmoud, Senthilkumar Sadhasivam, Anthony K Sestokas, Paul Samuels, John McAuliffe
No abstract text is available yet for this article.
February 2007: Anesthesiology
Antti Haapalinna, Tiina Leino, Esa Heinonen
The present experiments investigated the effects of the specific alpha(2)-adrenoceptor antagonist atipamezole, alone and in combination with a dopamine agonist, on motor function in rats with a unilateral 6-hydroxydopamine lesion of the nigro-striatal pathway and on exploratory behaviour and cardiovascular function in rats equipped with telemetry transmitters. Dexmedetomidine, an alpha(2)-adrenoceptor agonist and the alpha(2)-adrenoceptor antagonists idazoxan and yohimbine were used as reference compounds. In the unilaterally lesioned animals, direct dopamine agonists, such as apomorphine, induce contralateral turning behaviour...
November 2003: Naunyn-Schmiedeberg's Archives of Pharmacology
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