A randomized crossover study of the effects of lidocaine on motor- and sensory-evoked potentials during spinal surgery
| Autor: | Jonathan C. Beathe, Oheneba Boachie-Adjei, Kara G. Fields, Sean W. Donegan, Ronald G. Emerson, Michael K. Urban, David W. Pinter |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Lidocaine Context (language use) 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Evoked Potentials Somatosensory Monitoring Intraoperative medicine Humans Orthopedics and Sports Medicine Propofol business.industry Middle Aged Evoked Potentials Motor Crossover study Surgery Spinal Fusion Intravenous anesthesia Isoflurane Anesthesia Anesthetic Female Neurology (clinical) business Anesthetics Intravenous 030217 neurology & neurosurgery medicine.drug Intraoperative neurophysiological monitoring |
| Zdroj: | The Spine Journal. 17:1889-1896 |
| ISSN: | 1529-9430 |
| Popis: | Background Context Lidocaine has emerged as a useful adjuvant anesthetic agent for cases requiring intraoperative monitoring of motor-evoked potentials (MEPs) and somatosensory-evoked potentials (SSEPs). A previous retrospective study suggested that lidocaine could be used as a component of propofol-based intravenous anesthesia without adversely affecting MEP or SSEP monitoring, but did not address the effect of the addition of lidocaine on the MEP and SSEP signals of individual patients. Purpose The purpose of this study was to examine the intrapatient effects of the addition of lidocaine to balanced anesthesia on MEPs and SSEPs during multilevel posterior spinal fusion. Study Design This is a prospective, two-treatment, two-period crossover randomized controlled trial with a blinded primary outcome assessment. Patient Sample Forty patients undergoing multilevel posterior spinal fusion were studied. Outcome Measures The primary outcome measures were MEP voltage thresholds and SSEP amplitudes. Secondary outcome measures included isoflurane concentrations and hemodynamic parameters. Methods Each participant received two anesthetic treatments (propofol 50 mcg/kg/h and propofol 25 mcg/kg/h+lidocaine 1 mg/kg/h) along with isoflurane, ketamine, and diazepam. In this manner, each patient served as his or her own control. The order of administration of the two treatments was determined randomly. Results There were no significant within-patient differences between MEP threshold voltages or SSEP amplitudes during the two anesthetic treatments. Conclusions Lidocaine may be used as a component of balanced anesthesia during multilevel spinal fusions without adversely affecting the monitoring of SSEPs or MEPs in individual patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect