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Live Imaging of Dorsal Root Axons after Rhizotomy
06:39

Live Imaging of Dorsal Root Axons after Rhizotomy

Published on: September 1, 2011

Anesthesia for selective dorsal rhizotomy in children

E V Riegle1, J B Gunter, R G Lagueruela

  • 1Department of Pediatric Anesthesiology, St. Louis Children's Hospital, Washington University, St. Louis, Missouri 63110, USA.

Journal of Neurosurgical Anesthesiology
|July 1, 1992
PubMed

Insights

Anesthesia for selective dorsal rhizotomy (SDR) requires preserving nerve rootlet function. Halothane, isoflurane, and narcotics are suitable, but propofol causes unacceptable muscle spasms during SDR.

Area of Science:

  • Pediatric Anesthesiology
  • Neurosurgery
  • Neurophysiology

Background:

  • Selective dorsal rhizotomy (SDR) is a surgical procedure requiring precise electrophysiologic monitoring.
  • Maintaining muscle contraction during nerve rootlet stimulation is critical for SDR success.

Purpose of the Study:

  • To evaluate anesthetic agents' effects on electrophysiologic monitoring during pediatric SDR.
  • To identify anesthetic protocols that preserve neuromuscular function during SDR.

Main Methods:

  • Retrospective review of anesthetic records for 71 children undergoing SDR.
  • Analysis of anesthetic agents used and their impact on muscle response to electrical nerve stimulation.

Main Results:

  • Halothane, isoflurane, and narcotics did not interfere with electrophysiologic monitoring during SDR.
  • Propofol caused severe muscle spasms, rendering it unacceptable for SDR anesthesia.
  • Body temperature increases predictably during SDR stimulation; active warming should be avoided.

Conclusions:

  • Certain anesthetic agents (halothane, isoflurane, narcotics) are compatible with electrophysiologic monitoring in SDR.
  • Propofol is contraindicated for SDR due to interference with neuromuscular monitoring.
  • SDR anesthetic management should account for intraoperative temperature fluctuations.

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