The effects of propofol and isoflurane on intraoperative motor evoked potentials during spinal cord tumour removal surgery - A prospective randomised trial. 2019

Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
Division of Neurosurgery, Department of Surgical Oncology, Tata Memorial Centre, Advanced Centre for Treatment, Research and Education in Cancer, Sector-22, Kharghar, Navi Mumbai, Maharashtra, India.

OBJECTIVE Transcranial electrical stimulation (TES) elicited intraoperative motor evoked potentials (iMEPs), are suppressed by most anaesthetic agents. This prospective randomised study was carried out to compare the effects of Isoflurane and Propofol on iMEPs during surgery for spinal cord tumours. METHODS A total of 110 patients were randomly divided into two groups. In group P, anaesthesia was maintained with intravenous propofol (6.6 ± 1.5 mg/kg/hr) and in group I anaesthesia was maintained with isoflurane (0.8 ± 0.1% minimal alveolar concentration (MAC). An Oxygen- air mixture (FiO2-0.3) was used in both groups. TES-iMEPs were recorded from tibialis anterior, quadriceps, soleus and external anal sphincter muscles in 60 of 90 patients. Statistical analysis was performed with Pearson correlation and Paired 't' tests. RESULTS Successful baseline iMEPs were recorded in 74% of patients in Group P and in 50% of patients in Group I. Age and duration of symptoms influenced the elicitation of baseline iMEPs under isoflurane (r = -0.71, -0.66 respectively, P < 0.01) as compared to propofol (r = -0.60, -0.50 respectively, P < 0.01). The mean stimulus strength required to elicit the baseline iMEPs were lesser in propofol (205 ± 55Volts) as compared to isoflurane (274 ± 60 Volts). Suppression of the iMEP responses was less under propofol (7.3%) as compared to isoflurane anaesthesia (11.3%) in patients with no preoperative neurological deficits. CONCLUSIONS iMEPs are better maintained under propofol anaesthesia (6-8 mg/kg/hr) when compared with isoflurane (0.7-0.9 MAC). in patients undergoing surgery for excision of spinal cord tumours.

UI MeSH Term Description Entries

Related Publications

Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
October 1991, Neurosurgery,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
August 2004, Journal of clinical monitoring and computing,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
June 2015, Clinical neurology and neurosurgery,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
July 2014, Yonsei medical journal,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
March 2013, No shinkei geka. Neurological surgery,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
May 2023, Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
September 2015, Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
February 2019, Journal of neurosurgery. Spine,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
August 1997, Journal of spinal disorders,
Parthiban Velayutham, and Verghese T Cherian, and Vedantam Rajshekhar, and Krothapalli S Babu
January 2019, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society,
Copied contents to your clipboard!