The influence of depth of sedation on motor evoked potentials
monitoring in youth from 4 to 23 years old: preliminary data
from a prospective observational study

J 2024

The influence of depth of sedation on motor evoked potentials monitoring in youth from 4 to 23 years old: preliminary data from a prospective observational study

HUDEC, Jan, Martina KOSINOVÁ, Tereza PROKOPOVÁ, Hana ZELINKOVÁ, Kamil HUDÁČEK et. al.

Základní údaje

Originální název

The influence of depth of sedation on motor evoked potentials monitoring in youth from 4 to 23 years old: preliminary data from a prospective observational study

Autoři

HUDEC, Jan (203 Česká republika, domácí), Martina KOSINOVÁ (203 Česká republika, domácí), Tereza PROKOPOVÁ (203 Česká republika, domácí), Hana ZELINKOVÁ (203 Česká republika, domácí), Kamil HUDÁČEK (703 Slovensko, domácí), Martin REPKO (203 Česká republika, domácí), Roman GÁL (203 Česká republika, domácí) a Petr ŠTOURAČ (203 Česká republika, domácí)

Vydání

Frontiers in Medicine, LAUSANNE, FRONTIERS MEDIA SA, 2024, 2296-858X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30223 Anaesthesiology

Stát vydavatele

Švýcarsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.900 v roce 2022

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.3389/fmed.2024.1471450

UT WoS

001352018100001

Klíčová slova anglicky

bispectral index; intraoperative neurophysiological monitoring; motor evoked potentials; remifentanil; scoliosis surgery; total intravenous anesthesia

Štítky

14110217, 14110233, 14110322, 14110528, 14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 30. 1. 2025 07:37, Mgr. Tereza Miškechová

Anotace

V originále

Introduction The influence of various levels of sedation depth on motor evoked potentials (MEP) reproducibility in youth is still unclear because of a lack of data. We tested the hypothesis that a deeper level of total intravenous anesthesia (TIVA) [bispectral index (BIS) 40 +/- 5 compared to 60 +/- 5] can affect surgeon-directed MEP and their interpretation in youths.Methods All patients received TIVA combined with propofol and remifentanil. TIVA was initially maintained at a BIS level of 60 +/- 5. The sedation anesthesia was deepened to BIS level 40 +/- 5 before the skin incision. MEP were recorded and interpreted at both BIS levels. The primary endpoint was to evaluate the effect of the depth of sedation on the MEP reproducibility directed and interpreted by the surgical team in each patient separately. The secondary endpoint was to compare the relativized MEP parameters (amplitude and latency) in percentage at various levels of sedation in each patient separately. We planned to enroll 150 patients. Due to the COVID-19 pandemic, we decided to analyze the results of the first 50 patients.Results The surgical team successfully recorded and interpreted MEP in all 50 enrolled patients in both levels of sedation depth without any clinical doubts. The MEP parameters at BIS level 40 +/- 5, proportionally compared with the baseline, were latency 104% (97-110%) and the MEP amplitudes 84.5% (51-109%).Conclusion Preliminary data predict that deeper sedation (BIS 40 +/- 5) does not affect the surgical team's interpretation of MEP in youth patients. These results support that surgeon-directed MEP may be an alternative when neurophysiologists are unavailable.

Návaznosti

MUNI/A/1595/2023, interní kód MU

Název: Optimalizace bezpečnosti intenzivní a perioperační péče II

Investor: Masarykova univerzita, Optimalizace bezpečnosti intenzivní a perioperační péče II

MUNI/IVV/0770/2023, interní kód MU

Název: Zavedení objektivního strukturovaného klinické zkoušení (Objective Structured Clinical Examination) a související modifikace výuky předmětu Intenzivní medicína

Investor: Masarykova univerzita, Zavedení objektivního strukturovaného klinické zkoušení (Objective Structured Clinical Examination) a související modifikace výuky předmětu Intenzivní medicína

Citovat

HUDEC, Jan, Martina KOSINOVÁ, Tereza PROKOPOVÁ, Hana ZELINKOVÁ, Kamil HUDÁČEK, Martin REPKO, Roman GÁL a Petr ŠTOURAČ. The influence of depth of sedation on motor evoked potentials monitoring in youth from 4 to 23 years old: preliminary data from a prospective observational study. Frontiers in Medicine. LAUSANNE: FRONTIERS MEDIA SA, 2024, roč. 11, October 2024, s. 1-8. ISSN 2296-858X. Dostupné z: https://dx.doi.org/10.3389/fmed.2024.1471450.

@article{2453683,
   author = {Hudec, Jan and Kosinová, Martina and Prokopová, Tereza and Zelinková, Hana and Hudáček, Kamil and Repko, Martin and Gál, Roman and Štourač, Petr},
   article_location = {LAUSANNE},
   article_number = {October 2024},
   doi = {http://dx.doi.org/10.3389/fmed.2024.1471450},
   keywords = {bispectral index; intraoperative neurophysiological monitoring; motor evoked potentials; remifentanil; scoliosis surgery; total intravenous anesthesia},
   language = {eng},
   issn = {2296-858X},
   journal = {Frontiers in Medicine},
   title = {The influence of depth of sedation on motor evoked potentials monitoring in youth from 4 to 23 years old: preliminary data from a prospective observational study},
   url = {https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1471450/full},
   volume = {11},
   year = {2024}
}

TY  - JOUR
ID  - 2453683
AU  - Hudec, Jan - Kosinová, Martina - Prokopová, Tereza - Zelinková, Hana - Hudáček, Kamil - Repko, Martin - Gál, Roman - Štourač, Petr
PY  - 2024
TI  - The influence of depth of sedation on motor evoked potentials monitoring in youth from 4 to 23 years old: preliminary data from a prospective observational study
JF  - Frontiers in Medicine
VL  - 11
IS  - October 2024
SP  - 1-8
EP  - 1-8
PB  - FRONTIERS MEDIA SA
SN  - 2296858X
KW  - bispectral index
KW  - intraoperative neurophysiological monitoring
KW  - motor evoked potentials
KW  - remifentanil
KW  - scoliosis surgery
KW  - total intravenous anesthesia
UR  - https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1471450/full
N2  - Introduction The influence of various levels of sedation depth on motor evoked potentials (MEP) reproducibility in youth is still unclear because of a lack of data. We tested the hypothesis that a deeper level of total intravenous anesthesia (TIVA) [bispectral index (BIS) 40 +/- 5 compared to 60 +/- 5] can affect surgeon-directed MEP and their interpretation in youths.Methods All patients received TIVA combined with propofol and remifentanil. TIVA was initially maintained at a BIS level of 60 +/- 5. The sedation anesthesia was deepened to BIS level 40 +/- 5 before the skin incision. MEP were recorded and interpreted at both BIS levels. The primary endpoint was to evaluate the effect of the depth of sedation on the MEP reproducibility directed and interpreted by the surgical team in each patient separately. The secondary endpoint was to compare the relativized MEP parameters (amplitude and latency) in percentage at various levels of sedation in each patient separately. We planned to enroll 150 patients. Due to the COVID-19 pandemic, we decided to analyze the results of the first 50 patients.Results The surgical team successfully recorded and interpreted MEP in all 50 enrolled patients in both levels of sedation depth without any clinical doubts. The MEP parameters at BIS level 40 +/- 5, proportionally compared with the baseline, were latency 104% (97-110%) and the MEP amplitudes 84.5% (51-109%).Conclusion Preliminary data predict that deeper sedation (BIS 40 +/- 5) does not affect the surgical team's interpretation of MEP in youth patients. These results support that surgeon-directed MEP may be an alternative when neurophysiologists are unavailable.
ER  -

HUDEC, Jan, Martina KOSINOVÁ, Tereza PROKOPOVÁ, Hana ZELINKOVÁ, Kamil HUDÁČEK, Martin REPKO, Roman GÁL a Petr ŠTOURAČ. The influence of depth of sedation on motor evoked potentials monitoring in youth from 4 to 23 years old: preliminary data from a prospective observational study. \textit{Frontiers in Medicine}. LAUSANNE: FRONTIERS MEDIA SA, 2024, roč.~11, October 2024, s.~1-8. ISSN~2296-858X. Dostupné z: https://dx.doi.org/10.3389/fmed.2024.1471450.

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