• F Heid, D W Kauff, H Lang, and W Kneist.
• Department of Anaesthesiology, University Medicine of the Johannes Gutenberg-University Mainz, Mainz, Germany.
• Acta Anaesthesiol Scand. 2015 Oct 1; 59 (9): 1119-25.

BackgroundPelvic intraoperative neuromonitoring (pIONM) aims to identify and spare the autonomic nerves and maintain patients' quality of life. The effect of anaesthetic agents on the pIONM signal is unknown; therefore, the aim of the present study was to compare the influences of inhalation anaesthesia (IA) and total intravenous anaesthesia (TIVA).MethodsTwenty rectal cancer patients undergoing open nerve-sparing total mesorectal excision (TME) were assigned to pIONM under either IA or TIVA (n = 10 per group). IA was maintained with sevoflurane and TIVA with propofol. During surgery, pelvic autonomic nerves were electrically stimulated under electromyography (EMG) of the internal anal sphincter (IAS). These triggered EMG signals were analysed.ResultsThe absolute EMG amplitude during pIONM increased to 1.20 μV (interquartile range (IQR): 0.94-1.6) for IA and 1.49 μV (IQR: 0.84-2.75) for TIVA (P = 0.002). The relative EMG amplitude increase also was significantly lower for IA (0.59; IQR: 0.30-0.81; TIVA: 0.99; IQR: 0.62-2.5), (P = 0.001).ConclusionsThis is the first study to compare the influences of IA and TIVA on the autonomic nervous system. While both anaesthetic regimens proved useful for pIONM, TIVA with propofol may provide better signal quality than IA with sevoflurane.© 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

30 keywords...

hide…