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A pilot study to record visual evoked potentials during prone spine surgery using the SightSaver™ photic visual
E M Soffin1, R G Emerson2, J Cheng3
1Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. soffine@hss.edu.
Journal of Clinical Monitoring and Computing
|December 22, 2017
Summary
This pilot study shows the SightSaver mask safely records real-time visual evoked potentials (VEPs) during spine surgery. VEPs detected anesthesia changes, offering a new way to monitor visual function during complex procedures.
Area of Science:
- Neuroscience
- Ophthalmology
- Anesthesiology
Background:
- Intraoperative monitoring is crucial for patient safety during prone spine surgery.
- Assessing visual pathway integrity in real-time during surgery remains challenging.
Purpose of the Study:
- To evaluate the clinical safety and efficacy of the SightSaver mask for recording flash visual evoked potentials (VEPs) during prone spine surgery.
- To determine if VEPs can detect intraoperative visual insults.
Main Methods:
- A prospective, observational pilot study involving 20 patients undergoing spine surgery.
- Real-time flash VEPs were recorded using the SightSaver mask, with simultaneous somatosensory evoked potential (SSEP) monitoring.
- VEPs were qualitatively analyzed for presence, absence, and changes related to anesthesia and surgical events.
Main Results:
- Reproducible VEPs were obtained in 18/20 patients (90%).
- VEPs demonstrated high sensitivity to anesthetic agents (isoflurane, N2O), showing decrements not always reflected in SSEPs.
- The SightSaver mask was easy to use and well-tolerated, with no adverse effects.
Conclusions:
- The SightSaver mask is a safe and effective tool for real-time VEP recording during prone spine surgery under general anesthesia.
- VEP monitoring shows promise for detecting visual pathway insults during surgery.
- Further research is needed to optimize anesthetic regimens for stable VEP recording in this setting.
