Brain Tumor, Cerebral Aneurysm, General Anesthesia, Motor Evoked Potential Monitoring, Neurosurgery, Spine Tumor
Conditions
Keywords
Motor evoked potential monitoring, General Anesthesia, Neurosurgery, Cisatracurium, Vecuronium
Brief summary
Recently intraoperative motor evoked potential monitoring (MEP) is widely used to reduce neural damage during neurosurgery. As neuromuscular blockade(NMB) during MEP monitoring decreases the amplitude of MEP, partial NMB is usually maintained during general anesthesia. Continuous infusion of NMB agent is preferred than bolus infusion during MEP monitoring. There are a lot of NMB agents in clinical use. But there have been no reports about the effect of changing NMB agent on efficacy of MEP monitoring. Therefore, the investigators performed a randomized controlled trial to evaluate the effect of changing NMB agent on the variability of MEP amplitude during neurosurgery.
Detailed description
Recently intraoperative motor evoked potential monitoring (MEP) is widely used to reduce neural damage during neurosurgery. As neuromuscular blockade(NMB) during MEP monitoring decreases the amplitude of MEP, partial NMB is usually maintained during general anesthesia. Continuous infusion of NMB agent is preferred than bolus infusion during MEP monitoring. There are a lot of NMB agents in clinical use. But there have been no reports about the effect of changing NMB agent on efficacy of MEP monitoring. Therefore, the investigators performed a randomized controlled trial to evaluate the effect of changing NMB agent on the variability of MEP amplitude during neurosurgery.
Interventions
OTHERMEP monitoring with continuous infusion of vecuronium during general anesthesia
MEP monitoring with continuous infusion of vecuronium during general anesthesia
OTHERMEP monitoring with continuous infusion of cisatracurium during general anesthesia
MEP monitoring with continuous infusion of cisatracurium during general anesthesia
Sponsors
Samsung Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Adult patients undergoing neurosurgery with intraoperative motor evoked potential monitoring
Exclusion criteria
* Patients who can not undergo motor evoked potential monitoring due to central or peripheral neuromuscular disease (e.g. Cerebral palsy, Myasthenia gravis, Acute spinal injury, neurologic shock) * Patients with hepatic or renal disease with altered metabolism of vecuronium * Patients with medication which influence the metabolism of vecuronium (e.g. calcium channel blocker, aminoglycoside antibiotics, Lithium, MgSO4)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| MEP amplitude | 15 min after anesthetic induction | intraoperative motor evoked potential monitoring amplitude |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Coefficient of variation (CV) of MEP amplitude | at the end of the surgery (5H after the start of surgery) | Coefficient of variation (CV) of intraoperative motor evoked potential monitoring amplitude |
| Average of MEP amplitudes | at the end of the surgery (5H after the start of surgery) | Average of all measured MEP amplitudes in a subject |
| The frequency of adjusting the infusion dose of muscle relaxant | at the end of the surgery (5H after the start of surgery) | The frequency of adjusting the infusion dose of muscle relaxant |
| Average of Latency of MEP amplitude | at the end of the surgery (5H after the start of surgery) | Average of Latency of MEP amplitude |
Countries
South Korea
Outcome results
None listed