A comparison of the sensitivity of epidural and myogenic transcranial motor-evoked responses in the detection of acute spinal cord ischemia in the rabbit.
Identifieur interne : 002754 ( PubMed/Corpus ); précédent : 002753; suivant : 002755A comparison of the sensitivity of epidural and myogenic transcranial motor-evoked responses in the detection of acute spinal cord ischemia in the rabbit.
Auteurs : P. De Haan ; C J Kalkman ; L H Ubags ; M J Jacobs ; J C DrummondSource :
- Anesthesia and analgesia [ 0003-2999 ] ; 1996.
English descriptors
- KwdEn :
- Acute Disease, Animals, Aorta, Abdominal (physiopathology), Catheterization, Electric Stimulation (methods), Electromyography, Epidural Space, Evoked Potentials, Motor (physiology), Femoral Artery (physiopathology), Hindlimb (blood supply), Ischemia (diagnosis), Ischemia (physiopathology), Ligation, Lumbar Vertebrae, Monitoring, Intraoperative, Muscle, Skeletal (blood supply), Muscle, Skeletal (innervation), Neural Pathways (physiopathology), Peripheral Nerves (blood supply), Peripheral Nerves (physiopathology), Rabbits, Regional Blood Flow, Reperfusion, Risk Factors, Scalp, Spinal Cord (blood supply), Spinal Cord (physiopathology).
- MESH :
- blood supply : Hindlimb, Muscle, Skeletal, Peripheral Nerves, Spinal Cord.
- diagnosis : Ischemia.
- innervation : Muscle, Skeletal.
- methods : Electric Stimulation.
- physiology : Evoked Potentials, Motor.
- physiopathology : Aorta, Abdominal, Femoral Artery, Ischemia, Neural Pathways, Peripheral Nerves, Spinal Cord.
- Acute Disease, Animals, Catheterization, Electromyography, Epidural Space, Ligation, Lumbar Vertebrae, Monitoring, Intraoperative, Rabbits, Regional Blood Flow, Reperfusion, Risk Factors, Scalp.
Abstract
Monitoring motor-evoked responses to transcranial stimulation (tc-MERs) provides information about the functional status of the spinal cord during operations that pose the risk of spinal cord ischemia. Responses can be recorded from the epidural space (epidural tc-MERs) or from muscle (myogenic tc-MERs). In this study the relative sensitivity of epidural and myogenic tc-MERs to acute spinal cord ischemia was compared. Spinal cord ischemia was produced by infrarenal aortic balloon occlusion in nine anesthetized New Zealand White rabbits. Tc-MERs were evoked by transcranial electrical stimuli applied to the scalp. Responses were recorded from the lumbar epidural space and from the soleus muscle, and the effect of aortic occlusion was assessed. The peak-to-peak amplitude of the direct wave of the epidural response decreased gradually during aortic occlusion in eight animals and increased in one. The median (10th to 90th percentiles) time to a 50% reduction in amplitude was 11.3 (3-22) min. In contrast, myogenic responses disappeared within 2 min after the start of occlusion in all animals. Lower extremity ischemia as a cause of changes in myogenic tc-MER amplitude was excluded by ligating the right femoral artery and demonstrating that myogenic responses were preserved for 30 min, before occluding the aorta. We conclude that myogenic responses are more sensitive to acute spinal cord ischemia than epidural responses. The rapid detection of spinal cord ischemia with transcranial myogenic motor-evoked responses could be of clinical use in assessing the adequacy of spinal cord blood flow during operations where the spinal cord is at risk.
DOI: 10.1097/00000539-199611000-00021
PubMed: 8895279
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A comparison of the sensitivity of epidural and myogenic transcranial motor-evoked responses in the detection of acute spinal cord ischemia in the rabbit.</title><author><name sortKey="De Haan, P" sort="De Haan, P" uniqKey="De Haan P" first="P" last="De Haan">P. De Haan</name><affiliation><nlm:affiliation>Department of Anesthesiology, Academic Hospital, University of Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Kalkman, C J" sort="Kalkman, C J" uniqKey="Kalkman C" first="C J" last="Kalkman">C J Kalkman</name></author><author><name sortKey="Ubags, L H" sort="Ubags, L H" uniqKey="Ubags L" first="L H" last="Ubags">L H Ubags</name></author><author><name sortKey="Jacobs, M J" sort="Jacobs, M J" uniqKey="Jacobs M" first="M J" last="Jacobs">M J Jacobs</name></author><author><name sortKey="Drummond, J C" sort="Drummond, J C" uniqKey="Drummond J" first="J C" last="Drummond">J C Drummond</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1996">1996</date><idno type="RBID">pubmed:8895279</idno><idno type="pmid">8895279</idno><idno type="doi">10.1097/00000539-199611000-00021</idno><idno type="wicri:Area/PubMed/Corpus">002754</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002754</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A comparison of the sensitivity of epidural and myogenic transcranial motor-evoked responses in the detection of acute spinal cord ischemia in the rabbit.</title><author><name sortKey="De Haan, P" sort="De Haan, P" uniqKey="De Haan P" first="P" last="De Haan">P. De Haan</name><affiliation><nlm:affiliation>Department of Anesthesiology, Academic Hospital, University of Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Kalkman, C J" sort="Kalkman, C J" uniqKey="Kalkman C" first="C J" last="Kalkman">C J Kalkman</name></author><author><name sortKey="Ubags, L H" sort="Ubags, L H" uniqKey="Ubags L" first="L H" last="Ubags">L H Ubags</name></author><author><name sortKey="Jacobs, M J" sort="Jacobs, M J" uniqKey="Jacobs M" first="M J" last="Jacobs">M J Jacobs</name></author><author><name sortKey="Drummond, J C" sort="Drummond, J C" uniqKey="Drummond J" first="J C" last="Drummond">J C Drummond</name></author></analytic><series><title level="j">Anesthesia and analgesia</title><idno type="ISSN">0003-2999</idno><imprint><date when="1996" type="published">1996</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acute Disease</term><term>Animals</term><term>Aorta, Abdominal (physiopathology)</term><term>Catheterization</term><term>Electric Stimulation (methods)</term><term>Electromyography</term><term>Epidural Space</term><term>Evoked Potentials, Motor (physiology)</term><term>Femoral Artery (physiopathology)</term><term>Hindlimb (blood supply)</term><term>Ischemia (diagnosis)</term><term>Ischemia (physiopathology)</term><term>Ligation</term><term>Lumbar Vertebrae</term><term>Monitoring, Intraoperative</term><term>Muscle, Skeletal (blood supply)</term><term>Muscle, Skeletal (innervation)</term><term>Neural Pathways (physiopathology)</term><term>Peripheral Nerves (blood supply)</term><term>Peripheral Nerves (physiopathology)</term><term>Rabbits</term><term>Regional Blood Flow</term><term>Reperfusion</term><term>Risk Factors</term><term>Scalp</term><term>Spinal Cord (blood supply)</term><term>Spinal Cord (physiopathology)</term></keywords><keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Hindlimb</term><term>Muscle, Skeletal</term><term>Peripheral Nerves</term><term>Spinal Cord</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Ischemia</term></keywords><keywords scheme="MESH" qualifier="innervation" xml:lang="en"><term>Muscle, Skeletal</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Evoked Potentials, Motor</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Aorta, Abdominal</term><term>Femoral Artery</term><term>Ischemia</term><term>Neural Pathways</term><term>Peripheral Nerves</term><term>Spinal Cord</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Acute Disease</term><term>Animals</term><term>Catheterization</term><term>Electromyography</term><term>Epidural Space</term><term>Ligation</term><term>Lumbar Vertebrae</term><term>Monitoring, Intraoperative</term><term>Rabbits</term><term>Regional Blood Flow</term><term>Reperfusion</term><term>Risk Factors</term><term>Scalp</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Monitoring motor-evoked responses to transcranial stimulation (tc-MERs) provides information about the functional status of the spinal cord during operations that pose the risk of spinal cord ischemia. Responses can be recorded from the epidural space (epidural tc-MERs) or from muscle (myogenic tc-MERs). In this study the relative sensitivity of epidural and myogenic tc-MERs to acute spinal cord ischemia was compared. Spinal cord ischemia was produced by infrarenal aortic balloon occlusion in nine anesthetized New Zealand White rabbits. Tc-MERs were evoked by transcranial electrical stimuli applied to the scalp. Responses were recorded from the lumbar epidural space and from the soleus muscle, and the effect of aortic occlusion was assessed. The peak-to-peak amplitude of the direct wave of the epidural response decreased gradually during aortic occlusion in eight animals and increased in one. The median (10th to 90th percentiles) time to a 50% reduction in amplitude was 11.3 (3-22) min. In contrast, myogenic responses disappeared within 2 min after the start of occlusion in all animals. Lower extremity ischemia as a cause of changes in myogenic tc-MER amplitude was excluded by ligating the right femoral artery and demonstrating that myogenic responses were preserved for 30 min, before occluding the aorta. We conclude that myogenic responses are more sensitive to acute spinal cord ischemia than epidural responses. The rapid detection of spinal cord ischemia with transcranial myogenic motor-evoked responses could be of clinical use in assessing the adequacy of spinal cord blood flow during operations where the spinal cord is at risk.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">8895279</PMID><DateCompleted><Year>1996</Year><Month>12</Month><Day>04</Day></DateCompleted><DateRevised><Year>2019</Year><Month>07</Month><Day>04</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0003-2999</ISSN><JournalIssue CitedMedium="Print"><Volume>83</Volume><Issue>5</Issue><PubDate><Year>1996</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Anesthesia and analgesia</Title><ISOAbbreviation>Anesth. Analg.</ISOAbbreviation></Journal><ArticleTitle>A comparison of the sensitivity of epidural and myogenic transcranial motor-evoked responses in the detection of acute spinal cord ischemia in the rabbit.</ArticleTitle><Pagination><MedlinePgn>1022-7</MedlinePgn></Pagination><Abstract><AbstractText>Monitoring motor-evoked responses to transcranial stimulation (tc-MERs) provides information about the functional status of the spinal cord during operations that pose the risk of spinal cord ischemia. Responses can be recorded from the epidural space (epidural tc-MERs) or from muscle (myogenic tc-MERs). In this study the relative sensitivity of epidural and myogenic tc-MERs to acute spinal cord ischemia was compared. Spinal cord ischemia was produced by infrarenal aortic balloon occlusion in nine anesthetized New Zealand White rabbits. Tc-MERs were evoked by transcranial electrical stimuli applied to the scalp. Responses were recorded from the lumbar epidural space and from the soleus muscle, and the effect of aortic occlusion was assessed. The peak-to-peak amplitude of the direct wave of the epidural response decreased gradually during aortic occlusion in eight animals and increased in one. The median (10th to 90th percentiles) time to a 50% reduction in amplitude was 11.3 (3-22) min. In contrast, myogenic responses disappeared within 2 min after the start of occlusion in all animals. Lower extremity ischemia as a cause of changes in myogenic tc-MER amplitude was excluded by ligating the right femoral artery and demonstrating that myogenic responses were preserved for 30 min, before occluding the aorta. We conclude that myogenic responses are more sensitive to acute spinal cord ischemia than epidural responses. The rapid detection of spinal cord ischemia with transcranial myogenic motor-evoked responses could be of clinical use in assessing the adequacy of spinal cord blood flow during operations where the spinal cord is at risk.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>de Haan</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, Academic Hospital, University of Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kalkman</LastName><ForeName>C J</ForeName><Initials>CJ</Initials></Author><Author ValidYN="Y"><LastName>Ubags</LastName><ForeName>L H</ForeName><Initials>LH</Initials></Author><Author ValidYN="Y"><LastName>Jacobs</LastName><ForeName>M J</ForeName><Initials>MJ</Initials></Author><Author ValidYN="Y"><LastName>Drummond</LastName><ForeName>J C</ForeName><Initials>JC</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Anesth Analg</MedlineTA><NlmUniqueID>1310650</NlmUniqueID><ISSNLinking>0003-2999</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000208" MajorTopicYN="N">Acute Disease</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000818" MajorTopicYN="N">Animals</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001012" MajorTopicYN="N">Aorta, Abdominal</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002404" MajorTopicYN="N">Catheterization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004558" MajorTopicYN="N">Electric Stimulation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004576" MajorTopicYN="N">Electromyography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004824" MajorTopicYN="N">Epidural Space</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019054" MajorTopicYN="N">Evoked Potentials, Motor</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005263" MajorTopicYN="N">Femoral Artery</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006614" MajorTopicYN="N">Hindlimb</DescriptorName><QualifierName UI="Q000098" MajorTopicYN="N">blood supply</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007511" MajorTopicYN="N">Ischemia</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008026" MajorTopicYN="N">Ligation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008159" MajorTopicYN="N">Lumbar Vertebrae</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016343" MajorTopicYN="N">Monitoring, Intraoperative</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018482" MajorTopicYN="N">Muscle, Skeletal</DescriptorName><QualifierName UI="Q000098" MajorTopicYN="N">blood supply</QualifierName><QualifierName UI="Q000294" MajorTopicYN="Y">innervation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009434" MajorTopicYN="N">Neural Pathways</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010525" MajorTopicYN="N">Peripheral Nerves</DescriptorName><QualifierName UI="Q000098" MajorTopicYN="N">blood supply</QualifierName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011817" MajorTopicYN="N">Rabbits</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012039" MajorTopicYN="N">Regional Blood Flow</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015424" MajorTopicYN="N">Reperfusion</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012535" MajorTopicYN="N">Scalp</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013116" MajorTopicYN="N">Spinal Cord</DescriptorName><QualifierName UI="Q000098" MajorTopicYN="Y">blood supply</QualifierName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1996</Year><Month>11</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1996</Year><Month>11</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1996</Year><Month>11</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">8895279</ArticleId><ArticleId IdType="doi">10.1097/00000539-199611000-00021</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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