Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory Study
Study Design Prospective, randomized, placebo-controlled, double-blind exploratory study. Purpose To compare effects of dexmedetomidine or a subanesthetic dose of ketamine on the amplitude and latency of transcranial electrically generated motor evoked potentials. Overview of Literature Total intrav...
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| Format: | Article |
| Language: | English |
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Korean Spine Society
2022-04-01
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| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-2021-0015.pdf |
| _version_ | 1828788291223158784 |
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| author | Roshan Andleeb Sanjay Agrawal Priyanka Gupta |
| author_facet | Roshan Andleeb Sanjay Agrawal Priyanka Gupta |
| author_sort | Roshan Andleeb |
| collection | DOAJ |
| description | Study Design Prospective, randomized, placebo-controlled, double-blind exploratory study. Purpose To compare effects of dexmedetomidine or a subanesthetic dose of ketamine on the amplitude and latency of transcranial electrically generated motor evoked potentials. Overview of Literature Total intravenous anesthesia (TIVA) is a standard anesthesia technique for transcranial electrical motor evoked potential monitoring in spine surgery. We aimed to determine whether the use of dexmedetomidine and ketamine as a component of TIVA exerted any beneficial effect on the quality of monitoring. Methods A total of 90 American Society of Anesthesiologist grade I–III patients, aged 18–65 years, with a motor power of ≥4/5 grade as per the Medical Research Council Scale in all four limbs who were scheduled for elective spine surgery under transcranial electrical motor evoked potential monitoring were enrolled. The subjects were randomly allocated into the following three groups: group PD who received 0.5 μg/kg/hr dexmedetomidine infusion, group PK who received 0.5 mg/kg/hr ketamine infusion, and group PS who received normal saline infusion, along with standard propofol–fentanyl based TIVA regime. Amplitude and latency of bilateral motor evoked potentials of the tibialis anterior and abductor halluces muscle were recorded at Ti (at train-of-four ratio >90%), T30 (30 minutes post-Ti), T60 (60 minutes post-Ti), and Tf (at the end of spine manipulation). Results Baseline median amplitudes were comparable among the study groups. In group PK, we noted a gradually enhanced response by 24%–100% from the baseline amplitude. The median amplitudes of all the muscles were higher in group PK than those in groups PS and PD at time points T60 and Tf (p<0.05). Conclusions The present study demonstrated that compared with dexmedetomidine and control treatment, a subanesthetic dose of ketamine caused gradual improvement in amplitudes without affecting the latency. |
| first_indexed | 2024-12-12T00:49:53Z |
| format | Article |
| id | doaj.art-53cbc3bb2292410b9b3d762761becc2a |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-12T00:49:53Z |
| publishDate | 2022-04-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-53cbc3bb2292410b9b3d762761becc2a2022-12-22T00:44:02ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462022-04-0116222123010.31616/asj.2021.00151381Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory StudyRoshan Andleeb0Sanjay Agrawal1Priyanka Gupta2Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, IndiaDepartment of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, IndiaDepartment of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, IndiaStudy Design Prospective, randomized, placebo-controlled, double-blind exploratory study. Purpose To compare effects of dexmedetomidine or a subanesthetic dose of ketamine on the amplitude and latency of transcranial electrically generated motor evoked potentials. Overview of Literature Total intravenous anesthesia (TIVA) is a standard anesthesia technique for transcranial electrical motor evoked potential monitoring in spine surgery. We aimed to determine whether the use of dexmedetomidine and ketamine as a component of TIVA exerted any beneficial effect on the quality of monitoring. Methods A total of 90 American Society of Anesthesiologist grade I–III patients, aged 18–65 years, with a motor power of ≥4/5 grade as per the Medical Research Council Scale in all four limbs who were scheduled for elective spine surgery under transcranial electrical motor evoked potential monitoring were enrolled. The subjects were randomly allocated into the following three groups: group PD who received 0.5 μg/kg/hr dexmedetomidine infusion, group PK who received 0.5 mg/kg/hr ketamine infusion, and group PS who received normal saline infusion, along with standard propofol–fentanyl based TIVA regime. Amplitude and latency of bilateral motor evoked potentials of the tibialis anterior and abductor halluces muscle were recorded at Ti (at train-of-four ratio >90%), T30 (30 minutes post-Ti), T60 (60 minutes post-Ti), and Tf (at the end of spine manipulation). Results Baseline median amplitudes were comparable among the study groups. In group PK, we noted a gradually enhanced response by 24%–100% from the baseline amplitude. The median amplitudes of all the muscles were higher in group PK than those in groups PS and PD at time points T60 and Tf (p<0.05). Conclusions The present study demonstrated that compared with dexmedetomidine and control treatment, a subanesthetic dose of ketamine caused gradual improvement in amplitudes without affecting the latency.http://www.asianspinejournal.org/upload/pdf/asj-2021-0015.pdfspine surgerymotor evoked potentialsketaminedexmedetomidine |
| spellingShingle | Roshan Andleeb Sanjay Agrawal Priyanka Gupta Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory Study Asian Spine Journal spine surgery motor evoked potentials ketamine dexmedetomidine |
| title | Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory Study |
| title_full | Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory Study |
| title_fullStr | Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory Study |
| title_full_unstemmed | Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory Study |
| title_short | Evaluation of the Effect of Continuous Infusion of Dexmedetomidine or a Subanesthetic Dose Ketamine on Transcranial Electrical Motor Evoked Potentials in Adult Patients Undergoing Elective Spine Surgery under Total Intravenous Anesthesia: A Randomized Controlled Exploratory Study |
| title_sort | evaluation of the effect of continuous infusion of dexmedetomidine or a subanesthetic dose ketamine on transcranial electrical motor evoked potentials in adult patients undergoing elective spine surgery under total intravenous anesthesia a randomized controlled exploratory study |
| topic | spine surgery motor evoked potentials ketamine dexmedetomidine |
| url | http://www.asianspinejournal.org/upload/pdf/asj-2021-0015.pdf |
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