Elif Ilgaz Aydinlar1, Pinar Yalinay Dikmen1, Muge Kocak2, Nigar Baykan3, Nogayhan Seymen4, Memet Metin Ozek5. 1. Department of Neurology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey. 2. Departments of Neurology. 3. Anesthesiology and Reanimation, and. 4. Medical Biotechnology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey. 5. Department of Neurosurgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
Abstract
PURPOSE: The aim of this single-center prospective cohort study is to record reliable transcranial motor-evoked potentials (TcMEPs) and to determine their thresholds under inhalational anesthesia in infants undergoing spine and spinal cord surgery. METHODS: A total of 15 infants (age <12 months) with mean (SD) months: 5.82 ± 3.45 were included. The entry criteria were that the child should be no older than 1 year of age and undergoing a surgical procedure at the conus-cauda region. The patients were monitored with motor-evoked potentials (TcMEPs) and bulbocavernosus reflex. RESULTS: Transcranial motor-evoked potentials were recorded in all the patients in both upper and lower extremities in one muscle at least. All patients were monitored with a mean TcMEP threshold of 488.46 ± 99.76 V (range 310-740 V). The lowest threshold of TcMEPs was used to record the musculus abductor pollicis brevis mean of 315.15 ± 126.95 V (range 140-690 V) and the highest for musculus sphincter ani mean of 444.17 ± 138.54 V (range 206-700 V). CONCLUSIONS: Intraoperative neuromonitoring for spine and spinal cord procedures of the infant population requires higher TcMEP thresholds and train count. Most patients aged older than 6 months require significantly lower TcMEPs.
PURPOSE: The aim of this single-center prospective cohort study is to record reliable transcranial motor-evoked potentials (TcMEPs) and to determine their thresholds under inhalational anesthesia in infants undergoing spine and spinal cord surgery. METHODS: A total of 15 infants (age <12 months) with mean (SD) months: 5.82 ± 3.45 were included. The entry criteria were that the child should be no older than 1 year of age and undergoing a surgical procedure at the conus-cauda region. The patients were monitored with motor-evoked potentials (TcMEPs) and bulbocavernosus reflex. RESULTS: Transcranial motor-evoked potentials were recorded in all the patients in both upper and lower extremities in one muscle at least. All patients were monitored with a mean TcMEP threshold of 488.46 ± 99.76 V (range 310-740 V). The lowest threshold of TcMEPs was used to record the musculus abductor pollicis brevis mean of 315.15 ± 126.95 V (range 140-690 V) and the highest for musculus sphincter ani mean of 444.17 ± 138.54 V (range 206-700 V). CONCLUSIONS: Intraoperative neuromonitoring for spine and spinal cord procedures of the infant population requires higher TcMEP thresholds and train count. Most patients aged older than 6 months require significantly lower TcMEPs.
Authors: Sanne Lotte Journée; Henricus Louis Journée; Stephen Michael Reed; Hanneke Irene Berends; Cornelis Marinus de Bruijn; Cathérine John Ghislaine Delesalle Journal: Front Neurosci Date: 2020-07-17 Impact factor: 4.677
Authors: Tracy M Flanders; Alier J Franco; Scott J Hines; Jesse A Taylor; Gregory G Heuer Journal: Childs Nerv Syst Date: 2019-11-10 Impact factor: 1.475