Improved amplitude of myogenic motor evoked responses after paired transcranial electrical stimulation during sufentanil/nitrous oxide anesthesia.
Identifieur interne : 002815 ( PubMed/Corpus ); précédent : 002814; suivant : 002816Improved amplitude of myogenic motor evoked responses after paired transcranial electrical stimulation during sufentanil/nitrous oxide anesthesia.
Auteurs : C J Kalkman ; L H Ubags ; H D Been ; A. Swaan ; J C DrummondSource :
- Anesthesiology [ 0003-3022 ] ; 1995.
English descriptors
- KwdEn :
- MESH :
- chemical , pharmacology : Nitrous Oxide, Sufentanil.
- methods : Monitoring, Intraoperative.
- physiology : Brain, Muscles.
- Action Potentials, Adolescent, Adult, Aged, Anesthesia, Electric Stimulation, Female, Humans, Male, Middle Aged, Reaction Time.
Abstract
Measurement of motor evoked responses to transcranial stimulation (tc-MER) is a technique for intraoperative monitoring of motor pathways in the brain and spinal cord. However, clinical application of tc-MER monitoring is hampered because most anesthetic techniques severely depress the amplitude of motor evoked responses. Because paired electrical stimuli increase tc-MER responses in awake subjects, we examined their effects in anesthetized patients undergoing surgery. METHODS. Eleven patients whose neurologic condition was normal and who were undergoing spinal or aortic surgery were anesthetized with sufentanil-N20-ketamine. Partial neuromuscular blockade (single-twitch height 25% of baseline) was maintained with vecuronium. Single and paired electrical stimuli were delivered to the scalp, and compound action potentials were recorded from the tibialis anterior muscle. The amplitude and latency of the tc-MERs were measured as the interval between paired stimuli was varied between 0 (single stimulus) and 10 ms. All recordings were completed before spinal manipulation or aortic clamping.
DOI: 10.1097/00000542-199508000-00006
PubMed: 7631948
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pubmed:7631948Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Improved amplitude of myogenic motor evoked responses after paired transcranial electrical stimulation during sufentanil/nitrous oxide anesthesia.</title><author><name sortKey="Kalkman, C J" sort="Kalkman, C J" uniqKey="Kalkman C" first="C J" last="Kalkman">C J Kalkman</name><affiliation><nlm:affiliation>Department of Anesthesiology, Academic Medical Center, University of Amsterdam, The Netherlands.</nlm:affiliation></affiliation></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="Been, H D" sort="Been, H D" uniqKey="Been H" first="H D" last="Been">H D Been</name></author><author><name sortKey="Swaan, A" sort="Swaan, A" uniqKey="Swaan A" first="A" last="Swaan">A. Swaan</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="1995">1995</date><idno type="RBID">pubmed:7631948</idno><idno type="pmid">7631948</idno><idno type="doi">10.1097/00000542-199508000-00006</idno><idno type="wicri:Area/PubMed/Corpus">002815</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002815</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Improved amplitude of myogenic motor evoked responses after paired transcranial electrical stimulation during sufentanil/nitrous oxide anesthesia.</title><author><name sortKey="Kalkman, C J" sort="Kalkman, C J" uniqKey="Kalkman C" first="C J" last="Kalkman">C J Kalkman</name><affiliation><nlm:affiliation>Department of Anesthesiology, Academic Medical Center, University of Amsterdam, The Netherlands.</nlm:affiliation></affiliation></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="Been, H D" sort="Been, H D" uniqKey="Been H" first="H D" last="Been">H D Been</name></author><author><name sortKey="Swaan, A" sort="Swaan, A" uniqKey="Swaan A" first="A" last="Swaan">A. Swaan</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">Anesthesiology</title><idno type="ISSN">0003-3022</idno><imprint><date when="1995" type="published">1995</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Action Potentials</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Anesthesia</term><term>Brain (physiology)</term><term>Electric Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Monitoring, Intraoperative (methods)</term><term>Muscles (physiology)</term><term>Nitrous Oxide (pharmacology)</term><term>Reaction Time</term><term>Sufentanil (pharmacology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Nitrous Oxide</term><term>Sufentanil</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Monitoring, Intraoperative</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Brain</term><term>Muscles</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Action Potentials</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Anesthesia</term><term>Electric Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Reaction Time</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Measurement of motor evoked responses to transcranial stimulation (tc-MER) is a technique for intraoperative monitoring of motor pathways in the brain and spinal cord. However, clinical application of tc-MER monitoring is hampered because most anesthetic techniques severely depress the amplitude of motor evoked responses. Because paired electrical stimuli increase tc-MER responses in awake subjects, we examined their effects in anesthetized patients undergoing surgery. METHODS. Eleven patients whose neurologic condition was normal and who were undergoing spinal or aortic surgery were anesthetized with sufentanil-N20-ketamine. Partial neuromuscular blockade (single-twitch height 25% of baseline) was maintained with vecuronium. Single and paired electrical stimuli were delivered to the scalp, and compound action potentials were recorded from the tibialis anterior muscle. The amplitude and latency of the tc-MERs were measured as the interval between paired stimuli was varied between 0 (single stimulus) and 10 ms. All recordings were completed before spinal manipulation or aortic clamping.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">7631948</PMID><DateCompleted><Year>1995</Year><Month>09</Month><Day>07</Day></DateCompleted><DateRevised><Year>2019</Year><Month>06</Month><Day>28</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0003-3022</ISSN><JournalIssue CitedMedium="Print"><Volume>83</Volume><Issue>2</Issue><PubDate><Year>1995</Year><Month>Aug</Month></PubDate></JournalIssue><Title>Anesthesiology</Title><ISOAbbreviation>Anesthesiology</ISOAbbreviation></Journal><ArticleTitle>Improved amplitude of myogenic motor evoked responses after paired transcranial electrical stimulation during sufentanil/nitrous oxide anesthesia.</ArticleTitle><Pagination><MedlinePgn>270-6</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Measurement of motor evoked responses to transcranial stimulation (tc-MER) is a technique for intraoperative monitoring of motor pathways in the brain and spinal cord. However, clinical application of tc-MER monitoring is hampered because most anesthetic techniques severely depress the amplitude of motor evoked responses. Because paired electrical stimuli increase tc-MER responses in awake subjects, we examined their effects in anesthetized patients undergoing surgery. METHODS. Eleven patients whose neurologic condition was normal and who were undergoing spinal or aortic surgery were anesthetized with sufentanil-N20-ketamine. Partial neuromuscular blockade (single-twitch height 25% of baseline) was maintained with vecuronium. Single and paired electrical stimuli were delivered to the scalp, and compound action potentials were recorded from the tibialis anterior muscle. The amplitude and latency of the tc-MERs were measured as the interval between paired stimuli was varied between 0 (single stimulus) and 10 ms. All recordings were completed before spinal manipulation or aortic clamping.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Median amplitude of the tc-MER after a single stimulus was 106 microV (10th-90th percentiles: 23-1,042 microV), and the latency to onset was 33.2 +/- 1.4 ms (SD). With paired stimuli (interstimulus interval 2-3 ms), tc-MER amplitudes increased to 285 (79-1,605) microV, or 269% of the single-pulse response (P < 0.01). Reproducibility of individual responses increased with paired stimulation. Onset latency decreased to 31.4 +/- 3.2 ms (P < 0.05). Maximum amplitude augmentation was observed with interstimulus intervals between 2 and 5 ms and in patients with low-amplitude responses after single-pulse stimulation.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Application of paired transcranial electrical stimuli increases amplitudes and reproducibility of tc-MERs during anesthetic-induced depression of the motor system. The effect may represent temporal summation of stimulation at cortical or spinal sites. The results of this study warrant further clinical evaluation of paired transcranial stimulation.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kalkman</LastName><ForeName>C J</ForeName><Initials>CJ</Initials><AffiliationInfo><Affiliation>Department of Anesthesiology, Academic Medical Center, University of Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ubags</LastName><ForeName>L H</ForeName><Initials>LH</Initials></Author><Author ValidYN="Y"><LastName>Been</LastName><ForeName>H D</ForeName><Initials>HD</Initials></Author><Author ValidYN="Y"><LastName>Swaan</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Drummond</LastName><ForeName>J C</ForeName><Initials>JC</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Anesthesiology</MedlineTA><NlmUniqueID>1300217</NlmUniqueID><ISSNLinking>0003-3022</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>AFE2YW0IIZ</RegistryNumber><NameOfSubstance UI="D017409">Sufentanil</NameOfSubstance></Chemical><Chemical><RegistryNumber>K50XQU1029</RegistryNumber><NameOfSubstance UI="D009609">Nitrous Oxide</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000200" MajorTopicYN="N">Action Potentials</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000758" MajorTopicYN="Y">Anesthesia</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001921" MajorTopicYN="N">Brain</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004558" MajorTopicYN="N">Electric Stimulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016343" MajorTopicYN="N">Monitoring, Intraoperative</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009132" MajorTopicYN="N">Muscles</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009609" MajorTopicYN="N">Nitrous Oxide</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011930" MajorTopicYN="N">Reaction Time</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017409" MajorTopicYN="N">Sufentanil</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="Y">pharmacology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1995</Year><Month>8</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1995</Year><Month>8</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1995</Year><Month>8</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">7631948</ArticleId><ArticleId IdType="doi">10.1097/00000542-199508000-00006</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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