• Anthony C Wang, Khoi D Than, Arnold B Etame, Frank La Marca, and Paul Park.
• Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan 48109-5338, USA.
• Neurosurg Focus. 2009 Oct 1;27(4):E7.

ObjectTranscranial motor evoked potential (TcMEP) monitoring is frequently used in complex spinal surgeries to prevent neurological injury. Anesthesia, however, can significantly affect the reliability of TcMEP monitoring. Understanding the impact of various anesthetic agents on neurophysiological monitoring is therefore essential.MethodsA literature search of the National Library of Medicine database was conducted to identify articles pertaining to anesthesia and TcMEP monitoring during spine surgery. Twenty studies were selected and reviewed.ResultsInhalational anesthetics and neuromuscular blockade have been shown to limit the ability of TcMEP monitoring to detect significant changes. Hypothermia can also negatively affect monitoring. Opioids, however, have little influence on TcMEPs. Total intravenous anesthesia regimens can minimize the need for inhalational anesthetics.ConclusionsIn general, selecting the appropriate anesthetic regimen with maintenance of a stable concentration of inhalational or intravenous anesthetics optimizes TcMEP monitoring.

29 keywords...

hide…