A comparison of the effects of desflurane versus propofol on transcranial motor-evoked potentials in pediatric patients.

PURPOSE

The aim was to compare the effects of propofol and desflurane anesthesia on transcranial motor evoked potentials (MEPs) from pediatric patients undergoing surgery for spinal deformities.

METHODS

Desflurane and propofol cohorts (25 patients each) were obtained retrospectively and matched for patient characteristics and surgical approach. MEPs from the thenar eminence and abductor hallucis were compared during maintenance anesthesia on desflurane (0.6-0.8 MAC) or propofol infusion (150-300 μg/kg/min). MEP amplitudes and durations were obtained for successive 30-min intervals for 150 min, beginning 60 min after maintenance anesthesia.

RESULTS

Mean peak to peak amplitudes of MEPs under desflurane anesthesia from the thenar eminence (419 μV) and abductor hallucis (386 μv) were not significantly different from those under propofol (608 μV, 343 μV, thenar, and abductor hallucis, respectively). Stimulation was greater by 42 V and 136 mA, and trains were slightly longer in the desflurane compared to the propofol group (p < 0.05). Most MEP amplitudes for the desflurane and propofol cohorts remained the same or increased (71 % of cases) when those after 150 min were compared to those in the first 30-min interval.

CONCLUSIONS

MEPs with good amplitudes were obtained under desflurane only anesthesia that were comparable to propofol only anesthesia in pediatric patients during surgery for spinal deformities. There was no evidence for anesthetic fade over the time period examined. When used by itself, desflurane can be considered a viable alternative to propofol anesthesia.