Uribe Alberto A, Mendel Ehud, Peters Zoe A, Shneker Bassel F, Abdel-Rasoul Mahmoud, Bergese Sergio D
The Ohio State University Wexner Medical Center, Department of Anesthesiology, Columbus, OH, USA.
The Ohio State University Wexner Medical Center, Department of Neurological Surgery, Columbus, OH, USA.
Clin Neurophysiol. 2017 Oct;128(10):2006-2013. doi: 10.1016/j.clinph.2017.07.420. Epub 2017 Aug 9.
To determine the comparison of its clinical utility and safety profile for visual evoked potential (VEP) monitoring during prone spine surgeries under total intravenous anesthesia (TIVA) versus balanced general anesthesia using the SightSaver™ visual stimulator.
The protocol was designed asa pilot, single center, prospective, randomized, and double-arm study. Subjects were randomized to receive either TIVA or balanced general anesthesia. Following induction and intubation, 8 electrodes were placed subcutaneously to collect VEP recordings. The SightSaver™ visual stimulator was placed on the subject's scalp before prone positioning. VEP waveforms were recorded every 30min and assessed by a neurophysiologist throughout the length of surgery.
A total of 19 subjects were evaluated and VEP waveforms were successfully collected. TIVA group showed higher amplitude and lower latency than balanced anesthesia.
Our data suggested that TIVA is associated with higher VEP amplitude and shorter latencies than balanced general anesthesia; therefore, TIVA could be the most efficient anesthesia regimen for VEP monitoring.
The findings help to better understand the effect of different anesthesia regimens on intra-operative VEP monitoring.
比较在全静脉麻醉（TIVA）下俯卧位脊柱手术中使用SightSaver™视觉刺激器进行视觉诱发电位（VEP）监测与平衡全身麻醉的临床效用和安全性。
该方案设计为一项试点、单中心、前瞻性、随机双臂研究。受试者被随机分配接受TIVA或平衡全身麻醉。诱导和插管后，皮下放置8个电极以收集VEP记录。在俯卧位前将SightSaver™视觉刺激器放置在受试者头皮上。每30分钟记录一次VEP波形，并由神经生理学家在整个手术过程中进行评估。
共评估了19名受试者，成功收集了VEP波形。TIVA组比平衡麻醉组显示出更高的波幅和更低的潜伏期。
我们的数据表明，与平衡全身麻醉相比，TIVA与更高的VEP波幅和更短的潜伏期相关；因此，TIVA可能是用于VEP监测的最有效的麻醉方案。
这些发现有助于更好地理解不同麻醉方案对术中VEP监测的影响。
