Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1998-5-7
pubmed:abstractText
The goal of this study was to test the influence of two widespread techniques of general anesthesia on motor evoked potentials (MEP) in response to transcranial and direct cortical high frequency repetitive electrical stimulation. Total intravenous anesthesia (TIVA) based on propofol and alfentanil was examined in 17 patients (group A), and balanced anesthesia (BA), based on nitrous oxide, isoflurane and fentanyl, was studied in 13 patients (group B). Distinct motor responses were available in 15 of 17 patients (88%) of group A, and in one of 13 patients (8%) of group B. Amplitudes increased significantly with increasing stimulus intensity and number of pulses under conditions of TIVA. At the same time, latencies decreased significantly with increasing stimulus intensity and decreasing interstimulus interval, but not with increasing number of pulses. It is hypothesized that propofol suppresses corticospinal I-waves at the cortical level, resulting in a conduction block at the level of the alpha-motoneuron, and that this effect may be overcome by high frequency repetitive stimulation. In contrast, nitrous oxide and isoflurane seem to have an additional suppressive effect on corticospinal D-waves, which may be overcome by higher stimulation intensity. In conclusion, transcranial high frequency repetitive stimulation and TIVA provide a feasible setting for intraoperative MEP monitoring, while higher doses of nitrous oxide and isoflurane are not compatible with recording of muscular activity elicited by the stimulation technique as described.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0013-4694
pubmed:author
pubmed:issnType
Print
pubmed:volume
108
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
175-81
pubmed:dateRevised
2008-9-9
pubmed:meshHeading
pubmed-meshheading:9566630-Adolescent, pubmed-meshheading:9566630-Adult, pubmed-meshheading:9566630-Alfentanil, pubmed-meshheading:9566630-Anesthetics, Inhalation, pubmed-meshheading:9566630-Anesthetics, Intravenous, pubmed-meshheading:9566630-Cerebellar Neoplasms, pubmed-meshheading:9566630-Child, pubmed-meshheading:9566630-Electric Stimulation, pubmed-meshheading:9566630-Epilepsy, Temporal Lobe, pubmed-meshheading:9566630-Evoked Potentials, Motor, pubmed-meshheading:9566630-Female, pubmed-meshheading:9566630-Fentanyl, pubmed-meshheading:9566630-Glioma, pubmed-meshheading:9566630-Humans, pubmed-meshheading:9566630-Isoflurane, pubmed-meshheading:9566630-Male, pubmed-meshheading:9566630-Middle Aged, pubmed-meshheading:9566630-Monitoring, Intraoperative, pubmed-meshheading:9566630-Neurosurgery, pubmed-meshheading:9566630-Nitrous Oxide, pubmed-meshheading:9566630-Propofol, pubmed-meshheading:9566630-Sensory Thresholds
pubmed:year
1998
pubmed:articleTitle
Isoflurane plus nitrous oxide versus propofol for recording of motor evoked potentials after high frequency repetitive electrical stimulation.
pubmed:affiliation
Department of Neurosurgery, University of Bonn, Germany. UPechstein@compuserve.com
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Controlled Clinical Trial