Transcranial motor evoked potentials during anesthesia with desflurane versus propofol - A prospective randomized trial

M. J. Malcharek; S. Loeffler; D. Schiefer; M. A. Manceur; A. Sablotzki; J. Gille; S. Pilge; G. Schneider

doi:10.1016/j.clinph.2014.11.025

Transcranial motor evoked potentials during anesthesia with desflurane versus propofol - A prospective randomized trial

M. J. Malcharek, S. Loeffler, D. Schiefer, M. A. Manceur, A. Sablotzki, J. Gille, S. Pilge, G. Schneider

Research output: Contribution to journal › Article › peer-review

35 Scopus citations

Abstract

Objective: This study aimed to evaluate differences in transcranial electrical motor evoked potential (tcMEP) amplitudes between desflurane/remifentanil and propofol/remifentanil anesthesia treatment plans in patients without preexisting motor deficits (PMDs) undergoing carotid endarterectomy (CEA). Methods: This prospective trial included 21 patients who were randomly assigned to an effect group (Group^DESFLURANE; n=14) or a control group (Group^{STANDARD-PROPOFOL}; n=7). tcMEP amplitudes were measured 35min post-induction (T1) either with desflurane or propofol. Treatment was then changed to propofol in Group^DESFLURANE. After an additional 35min, the tcMEP amplitudes were reevaluated (T2). Differences in amplitudes (DW) between T1 and T2 were calculated for each patient, and the means of these differences were compared between groups. Results: tcMEPs were recorded in all 21 patients. At T1, the mean amplitude was 840.1 (SD 50.3)μV and 358.9 (SD 74)μV for Group^{STANDARD-PROPOFOL} and Group^DESFLURANE, respectively. The absolute mean difference (T1-T2) between groups was -496.75μV (p=0.0006). Conclusion: Desflurane reduces the tcMEP amplitude significantly more than propofol in patients without PMDs undergoing CEA. Significance: TcMEPs were recorded in all patients regardless of the anesthesia regimen. In patients with initially small amplitudes, desflurane may limit tcMEP recording because it produces a remarkable amplitude reduction, even in patients without PMDs.

Original language	English
Pages (from-to)	1825-1832
Number of pages	8
Journal	Clinical Neurophysiology
Volume	126
Issue number	9
DOIs	https://doi.org/10.1016/j.clinph.2014.11.025
State	Published - 1 Sep 2015
Externally published	Yes

Keywords

Desflurane
Intraoperative neurophysiologic monitoring
Motor evoked potentials
Propofol
Total intravenous anesthesia
Volatile anesthetics

Access to Document

10.1016/j.clinph.2014.11.025

Cite this

@article{e17006e816c344a89fd0cb53052a7e85,

title = "Transcranial motor evoked potentials during anesthesia with desflurane versus propofol - A prospective randomized trial",

abstract = "Objective: This study aimed to evaluate differences in transcranial electrical motor evoked potential (tcMEP) amplitudes between desflurane/remifentanil and propofol/remifentanil anesthesia treatment plans in patients without preexisting motor deficits (PMDs) undergoing carotid endarterectomy (CEA). Methods: This prospective trial included 21 patients who were randomly assigned to an effect group (GroupDESFLURANE; n=14) or a control group (GroupSTANDARD-PROPOFOL; n=7). tcMEP amplitudes were measured 35min post-induction (T1) either with desflurane or propofol. Treatment was then changed to propofol in GroupDESFLURANE. After an additional 35min, the tcMEP amplitudes were reevaluated (T2). Differences in amplitudes (DW) between T1 and T2 were calculated for each patient, and the means of these differences were compared between groups. Results: tcMEPs were recorded in all 21 patients. At T1, the mean amplitude was 840.1 (SD 50.3)μV and 358.9 (SD 74)μV for GroupSTANDARD-PROPOFOL and GroupDESFLURANE, respectively. The absolute mean difference (T1-T2) between groups was -496.75μV (p=0.0006). Conclusion: Desflurane reduces the tcMEP amplitude significantly more than propofol in patients without PMDs undergoing CEA. Significance: TcMEPs were recorded in all patients regardless of the anesthesia regimen. In patients with initially small amplitudes, desflurane may limit tcMEP recording because it produces a remarkable amplitude reduction, even in patients without PMDs.",

keywords = "Desflurane, Intraoperative neurophysiologic monitoring, Motor evoked potentials, Propofol, Total intravenous anesthesia, Volatile anesthetics",

author = "Malcharek, {M. J.} and S. Loeffler and D. Schiefer and Manceur, {M. A.} and A. Sablotzki and J. Gille and S. Pilge and G. Schneider",

note = "Publisher Copyright: {\textcopyright} 2014 International Federation of Clinical Neurophysiology.",

year = "2015",

month = sep,

day = "1",

doi = "10.1016/j.clinph.2014.11.025",

language = "English",

volume = "126",

pages = "1825--1832",

journal = "Clinical Neurophysiology",

issn = "1388-2457",

publisher = "Elsevier Ireland Ltd",

number = "9",

}

TY - JOUR

T1 - Transcranial motor evoked potentials during anesthesia with desflurane versus propofol - A prospective randomized trial

AU - Malcharek, M. J.

AU - Loeffler, S.

AU - Schiefer, D.

AU - Manceur, M. A.

AU - Sablotzki, A.

AU - Gille, J.

AU - Pilge, S.

AU - Schneider, G.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Objective: This study aimed to evaluate differences in transcranial electrical motor evoked potential (tcMEP) amplitudes between desflurane/remifentanil and propofol/remifentanil anesthesia treatment plans in patients without preexisting motor deficits (PMDs) undergoing carotid endarterectomy (CEA). Methods: This prospective trial included 21 patients who were randomly assigned to an effect group (GroupDESFLURANE; n=14) or a control group (GroupSTANDARD-PROPOFOL; n=7). tcMEP amplitudes were measured 35min post-induction (T1) either with desflurane or propofol. Treatment was then changed to propofol in GroupDESFLURANE. After an additional 35min, the tcMEP amplitudes were reevaluated (T2). Differences in amplitudes (DW) between T1 and T2 were calculated for each patient, and the means of these differences were compared between groups. Results: tcMEPs were recorded in all 21 patients. At T1, the mean amplitude was 840.1 (SD 50.3)μV and 358.9 (SD 74)μV for GroupSTANDARD-PROPOFOL and GroupDESFLURANE, respectively. The absolute mean difference (T1-T2) between groups was -496.75μV (p=0.0006). Conclusion: Desflurane reduces the tcMEP amplitude significantly more than propofol in patients without PMDs undergoing CEA. Significance: TcMEPs were recorded in all patients regardless of the anesthesia regimen. In patients with initially small amplitudes, desflurane may limit tcMEP recording because it produces a remarkable amplitude reduction, even in patients without PMDs.

AB - Objective: This study aimed to evaluate differences in transcranial electrical motor evoked potential (tcMEP) amplitudes between desflurane/remifentanil and propofol/remifentanil anesthesia treatment plans in patients without preexisting motor deficits (PMDs) undergoing carotid endarterectomy (CEA). Methods: This prospective trial included 21 patients who were randomly assigned to an effect group (GroupDESFLURANE; n=14) or a control group (GroupSTANDARD-PROPOFOL; n=7). tcMEP amplitudes were measured 35min post-induction (T1) either with desflurane or propofol. Treatment was then changed to propofol in GroupDESFLURANE. After an additional 35min, the tcMEP amplitudes were reevaluated (T2). Differences in amplitudes (DW) between T1 and T2 were calculated for each patient, and the means of these differences were compared between groups. Results: tcMEPs were recorded in all 21 patients. At T1, the mean amplitude was 840.1 (SD 50.3)μV and 358.9 (SD 74)μV for GroupSTANDARD-PROPOFOL and GroupDESFLURANE, respectively. The absolute mean difference (T1-T2) between groups was -496.75μV (p=0.0006). Conclusion: Desflurane reduces the tcMEP amplitude significantly more than propofol in patients without PMDs undergoing CEA. Significance: TcMEPs were recorded in all patients regardless of the anesthesia regimen. In patients with initially small amplitudes, desflurane may limit tcMEP recording because it produces a remarkable amplitude reduction, even in patients without PMDs.

KW - Desflurane

KW - Intraoperative neurophysiologic monitoring

KW - Motor evoked potentials

KW - Propofol

KW - Total intravenous anesthesia

KW - Volatile anesthetics

UR - http://www.scopus.com/inward/record.url?scp=84938985710&partnerID=8YFLogxK

U2 - 10.1016/j.clinph.2014.11.025

DO - 10.1016/j.clinph.2014.11.025

M3 - Article

C2 - 25541524

AN - SCOPUS:84938985710

SN - 1388-2457

VL - 126

SP - 1825

EP - 1832

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

IS - 9

ER -

Transcranial motor evoked potentials during anesthesia with desflurane versus propofol - A prospective randomized trial

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this