Fukuda Satoru
Department of Anesthesiology & Pain Medicine, Faculty of Medical Science, University of Fukui, Fukui 910-1193.
Masui. 2006 Mar;55(3):280-93.
Somatosensory evoked potential (SEP) has been widely used for monitoring the abnormal nerve conduction in various diseases. In non-anesthetized patients, Abeta fibers are electrically stimulated during SEP measurements. In anesthesiological field, it is used as a short latency somatosensory potential (SSEP), because its latency and amplitude are relatively constant. To detect the conduction abnormality from the upper extremities to the brain, median nerve stimulation is used. For the detection of spinal cord abnormality during operation, posterior tibial nerve stimulation is often used. It is important to know the origin of the wave appearing in SSEP to find the lesion in the nervous system. SSEP has been used in scoliosis surgery, carotid endarterectomy, thoracoabodominal aortic surgery and cervical operations to detect brain and spinal ischemia. In an intensive care unit, it is used for the diagnosis of brain death or ischemia and other neuronal diseases such as Guillain-Barre syndrome and polyneuritis etc. In pain clinic, laser evoked potential (LEP) has been recently introduced for the analysis of the mechanisms of nerve and spinal cord diseases. Using the LEP, pain mechanism would be clarified. During SSEP measurements, it is necessary for the anesthesiologists, intensivists and pain clinicians to understand the effect of anesthetic drugs and hypothermia on SSEP.