A pilot study to record visual evoked potentials during prone spine surgery using the SightSaver™ photic visual stimulator
| Autor: | J Cheng, K Smith, Ellen M. Soffin, James D. Beckman, Ronald G. Emerson, K Mercado |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty genetic structures Vision Disorders Pilot Projects Health Informatics Anesthesia General Critical Care and Intensive Care Medicine Patient Positioning Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Lumbar Risk Factors 030202 anesthesiology Evoked Potentials Somatosensory Monitoring Intraoperative Anesthesiology Prone Position Humans Medicine Prospective Studies Adverse effect Aged business.industry Middle Aged Spine Prone position Anesthesiology and Pain Medicine Isoflurane Somatosensory evoked potential Concomitant Anesthesia Anesthetic Evoked Potentials Visual Female business Photic Stimulation 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of Clinical Monitoring and Computing. 32:889-895 |
| ISSN: | 1573-2614 1387-1307 |
| Popis: | This is a pilot study to assess the clinical safety and efficacy of recording real-time flash visual evoked potentials (VEPs) using the SightSaver TM Visual Stimulator mask during prone spine surgery. A prospective, observational pilot study. Twenty patients presenting for spine surgery (microdiscectomy, 1–2 level lumbar fusion, or > 2 levels thoraco-lumbar fusion) were enrolled. The SightSaver™ Visual Stimulator™ was used to elicit VEPs throughout surgery. Somatosensory evoked potentials (SSEPs) were simultaneously recorded. All patients underwent general anesthesia with a combination of intravenous and inhaled agents. The presence, absence, and changes in VEP were qualitatively analyzed. Reproducible VEPs were elicited in 18/20 patients (36/40 eyes). VEPs were exquisitely sensitive to changes in anesthesia and decayed with rising MAC of isoflurane and/or N2O. Decrements in VEPs were observed without concomitant changes in SSEPs. The mask was simple to apply and use and was not associated with adverse effects. The SightSaver™ mask represents an emerging technology for monitoring developing visual insults during surgery. The definitive applications remain to be determined, but likely include use in select patients and/or surgeries. Here, we have validated the device as safe and effective, and show that VEPs can be recorded in real time under general anesthesia in the prone position. Future studies should be directed towards understanding the ideal anesthetic regimen to facilitate stable VEP recording during prone spine surgery. |
| Databáze: | OpenAIRE |
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