Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 1994
Another application of two-dimensional transesophageal echocardiography: spinal cord imaging. A preliminary report.
This prospective study was performed in 17 consecutive patients continuously monitored intraoperatively and postoperatively for cardiac function with two-dimensional (2D) TEE. Prior to systematic evaluation of spinal cord imaging by 2D TEE, the aims of this study were to determine: (1) the feasibility of such imaging, and (2) the relationship between spinal cord images and fixed structures (like vertebral bodies); 7.5 +/- 2.3 spinal segments were identified in the patients. ⋯ Successful imaging of the spinal cord was achieved in all 17 patients with visualization of discs, spinous processes, spinal canal, and a pulsating spinal cord. Further studies are needed to better define the potential applications of this new technique: detection of spinal cord trauma, visualization of a thoracic epidural catheter, and successful preservation of spinal cord vascularization during thoracic aortic surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 1994
A computer-controlled, closed-loop infusion system for infusing muscle relaxants: its use during motor-evoked potential monitoring.
A microcomputer-controlled closed-loop infusion system (MCCLIS) has been developed that provides stable intraoperative levels of partial neuromuscular blockade. Complete neuromuscular blockade interferes with intraoperative motor-evoked potential (MEP) monitoring used for patients undergoing surgical procedures that place them at risk for spinal cord ischemia. ⋯ Intraoperative adjustment of partial neuromuscular blockade to facilitate TcM-MEP monitoring was also possible with the MCCLIS. The MCCLIS should allow for further investigation into the sensitivity, specificity, and predictability of TcM-MEP monitoring for any patient at risk for intraoperative spinal cord ischemia including those undergoing thoracoabdominal aortic aneurysmectomy.