Low concentrations of isoflurane abolish motor evoked responses to transcranial electrical stimulation during nitrous oxide/opioid anesthesia in humans.
Identifieur interne : 000588 ( Ncbi/Merge ); précédent : 000587; suivant : 000589Low concentrations of isoflurane abolish motor evoked responses to transcranial electrical stimulation during nitrous oxide/opioid anesthesia in humans.
Auteurs : C J Kalkman ; J C Drummond ; A A RibberinkSource :
- Anesthesia and analgesia [ 0003-2999 ] ; 1991.
Descripteurs français
- KwdFr :
- MESH :
- analogues et dérivés : Fentanyl.
- pharmacologie : Isoflurane.
- Adulte, Adulte d'âge moyen, Analgésiques, Anesthésie, Humains, Motoneurones, Protoxyde d'azote, Période peropératoire, Stimulation électrique, Sufentanil.
English descriptors
- KwdEn :
- MESH :
- chemical , analogs & derivatives : Fentanyl.
- chemical , pharmacology : Isoflurane.
- chemical : Analgesics, Nitrous Oxide, Sufentanil.
- drug effects : Motor Neurons.
- Adult, Anesthesia, Electric Stimulation, Humans, Intraoperative Period, Middle Aged.
Abstract
To study the feasibility of noninvasive monitoring of motor pathways in anesthetized patients, we evaluated the effect of isoflurane on motor evoked responses to constant-voltage transcranial electrical stimulation (tce-MERs). Reproducible tce-MERs were recordable from the tibialis anterior muscle during nitrous oxide/opioid anesthesia in 11 patients. Before the introduction of isoflurane, tce-MER onset latency was 30.8 +/- 1.9 ms, and amplitude ranged from 19 microV to 2.6 mV (median, 209 microV). Operating conditions necessitated neuromuscular blockade in three patients before administration of isoflurane. In the remaining eight patients, introduction of isoflurane in low concentrations resulted in an immediate increase in the latency and a decrease in the amplitude of tce-MERs. The tce-MERs were completely obliterated in all subjects at end-tidal isoflurane concentrations between 0.2% and 0.6% (median, 0.24%). After discontinuation of isoflurane, the tce-MER returned in all patients. The authors conclude that, during nitrous oxide/opioid anesthesia, with the stimulus and recording variables used, isoflurane even at very low concentrations precludes recording of tce-MERs.
DOI: 10.1213/00000539-199110000-00008
PubMed: 1832825
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pubmed:1832825Le document en format XML
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Reproducible tce-MERs were recordable from the tibialis anterior muscle during nitrous oxide/opioid anesthesia in 11 patients. Before the introduction of isoflurane, tce-MER onset latency was 30.8 +/- 1.9 ms, and amplitude ranged from 19 microV to 2.6 mV (median, 209 microV). Operating conditions necessitated neuromuscular blockade in three patients before administration of isoflurane. In the remaining eight patients, introduction of isoflurane in low concentrations resulted in an immediate increase in the latency and a decrease in the amplitude of tce-MERs. The tce-MERs were completely obliterated in all subjects at end-tidal isoflurane concentrations between 0.2% and 0.6% (median, 0.24%). After discontinuation of isoflurane, the tce-MER returned in all patients. The authors conclude that, during nitrous oxide/opioid anesthesia, with the stimulus and recording variables used, isoflurane even at very low concentrations precludes recording of tce-MERs.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">1832825</PMID><DateCompleted><Year>1991</Year><Month>10</Month><Day>23</Day></DateCompleted><DateRevised><Year>2019</Year><Month>07</Month><Day>03</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0003-2999</ISSN><JournalIssue CitedMedium="Print"><Volume>73</Volume><Issue>4</Issue><PubDate><Year>1991</Year><Month>Oct</Month></PubDate></JournalIssue><Title>Anesthesia and analgesia</Title><ISOAbbreviation>Anesth. Analg.</ISOAbbreviation></Journal><ArticleTitle>Low concentrations of isoflurane abolish motor evoked responses to transcranial electrical stimulation during nitrous oxide/opioid anesthesia in humans.</ArticleTitle><Pagination><MedlinePgn>410-5</MedlinePgn></Pagination><Abstract><AbstractText>To study the feasibility of noninvasive monitoring of motor pathways in anesthetized patients, we evaluated the effect of isoflurane on motor evoked responses to constant-voltage transcranial electrical stimulation (tce-MERs). Reproducible tce-MERs were recordable from the tibialis anterior muscle during nitrous oxide/opioid anesthesia in 11 patients. Before the introduction of isoflurane, tce-MER onset latency was 30.8 +/- 1.9 ms, and amplitude ranged from 19 microV to 2.6 mV (median, 209 microV). Operating conditions necessitated neuromuscular blockade in three patients before administration of isoflurane. In the remaining eight patients, introduction of isoflurane in low concentrations resulted in an immediate increase in the latency and a decrease in the amplitude of tce-MERs. The tce-MERs were completely obliterated in all subjects at end-tidal isoflurane concentrations between 0.2% and 0.6% (median, 0.24%). After discontinuation of isoflurane, the tce-MER returned in all patients. The authors conclude that, during nitrous oxide/opioid anesthesia, with the stimulus and recording variables used, isoflurane even at very low concentrations precludes recording of tce-MERs.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kalkman</LastName><ForeName>C J</ForeName><Initials>CJ</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, University of California, San Diego, La Jolla 92093-0629.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Drummond</LastName><ForeName>J C</ForeName><Initials>JC</Initials></Author><Author ValidYN="Y"><LastName>Ribberink</LastName><ForeName>A A</ForeName><Initials>AA</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Anesth Analg</MedlineTA><NlmUniqueID>1310650</NlmUniqueID><ISSNLinking>0003-2999</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000700">Analgesics</NameOfSubstance></Chemical><Chemical><RegistryNumber>AFE2YW0IIZ</RegistryNumber><NameOfSubstance UI="D017409">Sufentanil</NameOfSubstance></Chemical><Chemical><RegistryNumber>CYS9AKD70P</RegistryNumber><NameOfSubstance UI="D007530">Isoflurane</NameOfSubstance></Chemical><Chemical><RegistryNumber>K50XQU1029</RegistryNumber><NameOfSubstance UI="D009609">Nitrous Oxide</NameOfSubstance></Chemical><Chemical><RegistryNumber>UF599785JZ</RegistryNumber><NameOfSubstance UI="D005283">Fentanyl</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000700" MajorTopicYN="Y">Analgesics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000758" MajorTopicYN="Y">Anesthesia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004558" MajorTopicYN="N">Electric Stimulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005283" MajorTopicYN="Y">Fentanyl</DescriptorName><QualifierName UI="Q000031" MajorTopicYN="Y">analogs & derivatives</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007432" MajorTopicYN="N">Intraoperative Period</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007530" MajorTopicYN="N">Isoflurane</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009046" MajorTopicYN="N">Motor Neurons</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009609" MajorTopicYN="Y">Nitrous Oxide</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017409" MajorTopicYN="N">Sufentanil</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1991</Year><Month>10</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1991</Year><Month>10</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1991</Year><Month>10</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">1832825</ArticleId><ArticleId IdType="doi">10.1213/00000539-199110000-00008</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list></list><tree><noCountry><name sortKey="Drummond, J C" sort="Drummond, J C" uniqKey="Drummond J" first="J C" last="Drummond">J C Drummond</name><name sortKey="Kalkman, C J" sort="Kalkman, C J" uniqKey="Kalkman C" first="C J" last="Kalkman">C J Kalkman</name><name sortKey="Ribberink, A A" sort="Ribberink, A A" uniqKey="Ribberink A" first="A A" last="Ribberink">A A Ribberink</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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