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Improvement of motor-evoked potentials by ketamine and spatial facilitation during spinal surgery in a young child
Thomas O Erb1, Sven E Ryhult, Ewald Duitmann
1*Department of Pediatric Orthopedic Surgery, †Department of Pediatric Neurology and Neurophysiology. University Children's Hospital Beider Basel, Basel, Switzerland.
Insights
Monitoring motor evoked potentials in children undergoing spine surgery is challenging due to anesthesia. This study successfully used ketamine anesthesia and a novel stimulation technique for reliable signal acquisition.
Area of Science:
- Neuroscience
- Anesthesiology
- Spine Surgery
Background:
- Motor evoked potentials (MEPs) monitoring is crucial during spine surgery for neurological assessment.
- Obtaining reliable MEPs in pediatric patients can be difficult due to anesthetic agents and patient size.
Observation:
- A case study involving a young child undergoing spine surgery is presented.
- Challenges in MEP monitoring in pediatric anesthesia were noted.
Findings:
- Successful MEP monitoring was achieved in a pediatric patient.
- A ketamine-based anesthesia regimen was employed.
- A novel stimulation technique combining spatial and temporal facilitation was utilized.
Implications:
- This approach may improve the feasibility and reliability of MEP monitoring in pediatric spine surgery.
- The findings suggest a potential method to overcome anesthetic interference with MEPs in young children.
- Further research into this combined stimulation technique could enhance intraoperative neurophysiological monitoring.
Abstract:
Monitoring motor evoked potentials is desirable during spine surgery but may be difficult to obtain in small children. In addition, the recording of reliable signals is often hampered by the presence of various anesthetics. We report the case of a young child whose motor evoked potentials were successfully monitored using a ketamine-based anesthesia and a newly introduced stimulation technique consisting of combined spatial and temporal facilitation.
