TY - JOUR
T1 - A computer-controlled, closed-loop infusion system for infusing muscle relaxants
T2 - Its use during motor-evoked potential monitoring
AU - Stinson, Lawrence W.
AU - Murray, Michael J.
AU - Jones, Keith A.
AU - Assef, Saied J.
AU - Burke, Michael J.
AU - Behrens, Terrence L.
AU - Lennon, Robert L.
PY - 1994/2
Y1 - 1994/2
N2 - 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 motorevoked potential (MEP) monitoring used for patients undergoing surgical procedures that place them at risk for spinal cord ischemia. Nine patients were studied during which the MCCLIS maintained stable levels of partial neuromuscular blockade and allowed transcranial magnetic motor-evoked potential (TcM-MEP) monitoring during thoracoabdominal aortic aneurysmectomy. The use of TcM-MEP for monitoring intraoperative spinal cord function was balanced against surgical considerations for muscle relaxation with 80% to 90% neuromuscular blockade fulfilling each requirement. 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 thoracoobdominal aortic aneurysmectomy.
AB - 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 motorevoked potential (MEP) monitoring used for patients undergoing surgical procedures that place them at risk for spinal cord ischemia. Nine patients were studied during which the MCCLIS maintained stable levels of partial neuromuscular blockade and allowed transcranial magnetic motor-evoked potential (TcM-MEP) monitoring during thoracoabdominal aortic aneurysmectomy. The use of TcM-MEP for monitoring intraoperative spinal cord function was balanced against surgical considerations for muscle relaxation with 80% to 90% neuromuscular blockade fulfilling each requirement. 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 thoracoobdominal aortic aneurysmectomy.
KW - descending thoracic aortic aneurysm
KW - postoperative paraplegia
KW - thorscoabdominal aortic aneurysm
UR - http://www.scopus.com/inward/record.url?scp=0027976838&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0027976838&partnerID=8YFLogxK
U2 - 10.1016/1053-0770(94)90010-8
DO - 10.1016/1053-0770(94)90010-8
M3 - Article
C2 - 7909456
AN - SCOPUS:0027976838
SN - 1053-0770
VL - 8
SP - 40
EP - 44
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 1
ER -