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Noxious stimuli do not modify myogenic motor evoked potentials by electrical stimulation during anesthesia with propofol-based anesthesia

[Des stimuli douloureux ne modifient pas les potentiels évoqués myogènes moteurs obtenus par stimulation électrique pendant l’anesthésie à base de propofol]

Satoki Inoue, MD^*, Masahiko Kawaguchi, MD^*, Masahiro Takahashi, MD^*, Meiko Kakimoto, MD^*, Takanori Sakamoto, MD^*, Katsuyasu Kitaguchi, MD^*, Hitoshi Furuya, MD^*, Tetsuya Morimoto, MD and Toshisuke Sakaki, MD

^* From the Department of Anesthesiology and
Neurosurgery Nara Medical University Japan

Address correspondence to: Dr. Satoki Inoue, Department of Anesthesiology, Neuroanesthesia Research, VA Medical Center, UCSD, 3350 La Jolla Village Drive, San Diego, California 92161, USA. Phone: 858-552-8585, ext. 7086; Fax: 858-534-0104; E-mail: sinoue{at}vapop.ucsd.edu

Purpose: To investigate whether motor evoked potentials (MEP) to transcranial electrical stimulation under constant blood propofol concentration are affected by the arousing effect of surgical noxious stimuli.

Methods: Twenty patients who underwent elective spinal surgery were studied. Patients were anesthetized with 50% nitrous oxide in oxygen, fentanyl, and propofol to maintain the bispectral index (BIS) score around 50. MEP in response to a multipulse transcranial electrical stimulation at stimulus sites of C3–C4 were recorded over the right abductor pollicis brevis muscle. Changes of peak-to-peak amplitude and onset latency of MEP, BIS score before and after surgical stimuli were evaluated. Propofol plasma concentration was measured at the same time points.

Results: Both MEP amplitude and latency did not change significantly after surgical stimuli although BIS increased significantly (48 ± 6 to 58 ± 5; P < 0.05). Plasma propofol concentration was maintained at the same level between the two measurement points (3.3 ± 0.7 to 3.3 ± 0.7 µg•mL^-1). There was no relation between BIS change and changes of MEP amplitude and latency, and propofol plasma concentration.

Conclusion: MEP to the transcranial electrical stimulation under a constant and clinically appropriate blood propofol concentration are not affected by surgical noxious stimuli.

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				N. Nathan, F. Tabaraud, F. Lacroix, D. Moulies, X. Viviand, A. Lansade, G. Terrier, and P. Feiss Influence of propofol concentrations on multipulse transcranial motor evoked potentials Br. J. Anaesth., October 1, 2003; 91(4): 493 - 497. [Abstract] [Full Text] [PDF]