Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Division of Neurology, Kobe University Graduate School of Medicine, Kobe, Japan.
Clin Neurophysiol. 2021 Aug;132(8):1919-1926. doi: 10.1016/j.clinph.2021.04.021. Epub 2021 Jun 1.
In order to evaluate the clinical utility even under general anesthesia, the present study aimed to clarify the effect of anesthesia on the cortico-cortical evoked potentials (CCEPs).
We analyzed 14 patients' data in monitoring the integrity of the dorsal language pathway by using CCEPs both under general anesthesia with propofol and remifentanil and awake condition, with the main aim of clarifying the effect of anesthesia on the distribution and waveform of CCEPs.
The distribution of larger CCEP response sites, including the locus of the maximum CCEP response site, was marginally affected by anesthesia. With regard to similarity of waveforms, the mean waveform correlation coefficient indicated a strong agreement. CCEP N1 amplitude increased by an average of 25.8% from general anesthesia to waking, except three patients. CCEP N1 latencies had no correlation in changes between the two conditions.
We demonstrated that the distribution of larger CCEP responses was marginally affected by anesthesia and that the CCEP N1 amplitude had tendency to increase from general anesthesia to the awake condition.
The CCEP method provides the efficiency of intraoperative monitoring for dorsal language white matter pathway even under general anesthesia.
为了评估全身麻醉下的临床实用性，本研究旨在阐明麻醉对皮质-皮质诱发电位（CCEPs）的影响。
我们分析了 14 例患者在全身麻醉下使用丙泊酚和瑞芬太尼以及清醒状态下监测背侧语言通路完整性的数据，主要目的是阐明麻醉对 CCEPs 的分布和波形的影响。
较大的 CCEP 反应部位的分布，包括最大 CCEP 反应部位的位置，受麻醉影响较小。关于波形的相似性，平均波形相关系数表明有很强的一致性。除了 3 名患者外，CCEP N1 振幅从全身麻醉到清醒时平均增加了 25.8%。CCEP N1 潜伏期在两种情况下的变化之间没有相关性。
我们表明，较大的 CCEP 反应的分布受麻醉影响较小，并且 CCEP N1 振幅有从全身麻醉到清醒状态增加的趋势。
CCEP 方法即使在全身麻醉下也能提供对背侧语言白质通路术中监测的效率。
