Health Condition 1: null- â?? Any patient posted for neurosurgery who requires motor evoked potential monitoring intraoperatively
Conditions
Interventions
Control Intervention1: P group: P group - propofol at a rate of 75- 100 μg/kg/min intravenous for the surgical duration
Control Intervention2: D group: dexmedetomidine loading dose at a rate of 0.5
Sponsors
Sree chitra institute for medical sciences and technology
Eligibility
Inclusion criteria
Inclusion criteria: 1. patient presenting for any spinal or intracranial surgery for a lesion involving motor cortex or pyramidal tract requiring intraoperative MEP monitoring
Exclusion criteria
Exclusion criteria: 1. Patient refusal 2. Age less than 18 years and more than 60 years. 3. Autonomic instability 4. Long standing Diabetes mellitus ( > 10 years) 5. Pregnant & nursing mothers 6. Motor power grade 7. Neuromuscular disease 8. Cardiopulmonary disease 9. skull defects at the region where electrodes need to be placed 10. intracranial apparatus (electrodes, vascular clips, and shunts), cardiac pacemakers, or other implanted pumps 11. renal and hepatic disease 12. history of chronic alcohol use 13. allergy to any of the anaesthetic agents used in the study 14. Preoperative heart rate 15. Antihypertensive medication with alpha methyl dopa, clonidine 16. Patient on beta blockers
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Amplitude of motor evoked potential (decrease of 50% or more from baseline) Latency of motor evoked potential (increase of 10% or more from baseline) Timepoint: T1 - baseline value of MEP obtained when the T4/T1 reaches 0.9, and before dividing the patients to two groups T2 - 10 min after T1 when the dexmedetomidine loading dose infusion would have just finished in D group. T3- 10 minutes after T2 T4 â?? 10 minutes after T3 T5, T6 â?? recorded during the procedure Tx â?? any other time if surgery requires it Te â?? at the end of surgery | — |
Secondary
| Measure | Time frame |
|---|---|
| heart rate, mean blood pressure trend (hemodynamic stability ) Amount of anaesthetic agents (amount of propofol and dexmedetomidine required) Complications â?? Bradycardia (heart rate 50 bpm), Hypotension or hypertension (decrease or increase in blood pressure 20% from baseline), frequency of complications like unwanted limb movement or respiratory efforts, injury at the insertion site of electrodes and tongue laceration. Time of recovery Timepoint: Throghout the intraoperative period. | — |
Countries
India
Contacts
Public Contactsoniya biswas
Sree chitra institute for medical sciences and technology
Outcome results
None listed