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Impact of low-dose sevoflurane with propofol-based anaesthesia on motor-evoked potentials in infants: protocol for a

Taiki Kojima1,2, Hirofumi Nakahari3, Michihiro Kurimoto4

  • 1Department of Anesthesiology, Aichi Children's Health and Medical Center, Obu, Aichi, Japan daiki_kojima@sk00106.achmc.pref.aichi.jp.

BMJ Open
|July 27, 2024
PubMed

Insights

This study investigates how low-dose sevoflurane affects motor-evoked potentials (MEPs) in infants receiving propofol-based anesthesia during spinal surgery. Findings will clarify MEP responses in pediatric anesthesia, aiding nerve injury prevention.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Neurophysiology

Background:

  • Motor-evoked potentials (MEPs) are crucial for monitoring nerve integrity during surgery, especially in infants.
  • Infants' developing nervous systems make them more vulnerable to anesthetic effects on MEPs.
  • The impact of combined low-dose sevoflurane and propofol-based total intravenous anesthesia (TIVA) on infant MEPs remains controversial.

Purpose of the Study:

  • To evaluate the effect of co-administering low-dose sevoflurane with propofol-based TIVA on MEPs in infants undergoing spinal surgery.
  • To determine if low-dose sevoflurane alters MEP amplitudes in this pediatric population.

Main Methods:

  • A randomized controlled trial involving infants (35-87 weeks postconceptual age) undergoing spinal surgery.
  • Participants randomly assigned to receive propofol+remifentanil with or without low-dose sevoflurane (0.10-0.15 MAC).
  • MEP amplitudes measured at two time points (T1, T2) to assess reduction (T1-T2) in upper and lower extremities.

Main Results:

  • The study aims to compare the reduction in MEP amplitudes between the control and intervention groups.
  • Primary endpoint: reduction in MEP amplitudes in the right upper extremity.
  • Secondary endpoint: reduction in MEP amplitudes in the right lower extremity.

Conclusions:

  • The findings will provide critical data on the interaction between sevoflurane and propofol anesthesia in infants.
  • This research aims to optimize anesthetic protocols to minimize the risk of nerve injury during pediatric spinal surgery.
  • Results will contribute to safer anesthetic practices for vulnerable infant populations.
Abstract

Keywords:
NEUROPHYSIOLOGYPaediatric anaesthesiaPropofol

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