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Anesthesia Influence on Recording: Summary

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Neurophysiology and Standards of Spinal Cord Monitoring

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Abstract

The advancements in various medical fields enhanced spinal surgery and increased the volume of more aggressive procedures. These operations have been associated with altered spinal function and different methods have been proposed to minimize such risk. Among these are local anesthesia, wake-up test, and more recently evoked potentials. Local anesthesia for spinal surgery is not practical and the wake-up test is limited to the time of testing. Somatosensory evoked potentials (SSEP), a safe, noninvasive, easy, and continuous technique for assessing the functional integrity of the spinal cord, offers a valuable alternative. However, many factors such as anesthesia, pharmacology, physiology, and technical errors can limit the value of evoked potentials. Nonsurgical factors account for 40% of SSEP changes and 25% of these changes are related to anesthesia (16). The yield of surgical monitoring is enhanced by the reduction of nonsurgical factors. The appreciation of anesthetic effects, comprehension of the triangle of anesthesia, and better utilization of such information decrease nonsurgical factors and increase the value of SSEP monitoring. A stable level of anesthesia and hemodynamics facilitates the differential diagnosis of SSEP changes. Intravenous anesthesia supplemented with low concentration of volatile agents offers that level of stability and may be an ideal technique for SSEP monitoring.

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Author information

Authors and Affiliations

  1. Director of Neurosurgical Anaesthesia, Northwestern University, 303 E. Chicago Avenue, Chicago, IL, 60611, USA

    A. Koht

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  1. A. Koht
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Editors and Affiliations

  1. University of Maryland, Baltimore, MD, USA

    Thomas B. Ducker M.D., F.A.C.S. (Clinical Professor, Associate Professor) (Clinical Professor, Associate Professor)

  2. Johns Hopkins University, Baltimore, MD, USA

    Thomas B. Ducker M.D., F.A.C.S. (Clinical Professor, Associate Professor) (Clinical Professor, Associate Professor)

  3. Division of Surgical Research, St. Luke’s Spine Center, Cleveland, OH, USA

    Richard H. Brown Ph.D (Director, Research Director) (Director, Research Director)

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© 1988 Springer-Verlag New York Inc.

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Koht, A. (1988). Anesthesia Influence on Recording: Summary. In: Ducker, T.B., Brown, R.H. (eds) Neurophysiology and Standards of Spinal Cord Monitoring. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3804-1_23

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  • DOI: https://doi.org/10.1007/978-1-4612-3804-1_23

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-8359-1

  • Online ISBN: 978-1-4612-3804-1

  • eBook Packages: Springer Book Archive

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