A bispectral index guided comparative evaluation of dexmedetomidine as an adjuvant to propofol-based total intravenous anaesthesia in spine surgeries done under motor-evoked potential monitoring
Anand, A., Kumar, S., Kumar, V., Giri, M., Das, P., Sharma, D. (2023). A bispectral index guided comparative evaluation of dexmedetomidine as an adjuvant to propofol-based total intravenous anaesthesia in spine surgeries done under motor-evoked potential monitoring. EKB Journal Management System, 15(1), -. doi: 10.1186/s42077-023-00379-7
Anshuman Anand; Suraj Kumar; Virendra Kumar; Manoj Kumar Giri; Praveen Kumar Das; Deepti Sharma. "A bispectral index guided comparative evaluation of dexmedetomidine as an adjuvant to propofol-based total intravenous anaesthesia in spine surgeries done under motor-evoked potential monitoring". EKB Journal Management System, 15, 1, 2023, -. doi: 10.1186/s42077-023-00379-7
Anand, A., Kumar, S., Kumar, V., Giri, M., Das, P., Sharma, D. (2023). 'A bispectral index guided comparative evaluation of dexmedetomidine as an adjuvant to propofol-based total intravenous anaesthesia in spine surgeries done under motor-evoked potential monitoring', EKB Journal Management System, 15(1), pp. -. doi: 10.1186/s42077-023-00379-7
Anand, A., Kumar, S., Kumar, V., Giri, M., Das, P., Sharma, D. A bispectral index guided comparative evaluation of dexmedetomidine as an adjuvant to propofol-based total intravenous anaesthesia in spine surgeries done under motor-evoked potential monitoring. EKB Journal Management System, 2023; 15(1): -. doi: 10.1186/s42077-023-00379-7

A bispectral index guided comparative evaluation of dexmedetomidine as an adjuvant to propofol-based total intravenous anaesthesia in spine surgeries done under motor-evoked potential monitoring

Ain-Shams Journal of Anesthesiology
Volume 15, Issue 1, January 2023  XML PDF (965.35 K)
DOI: 10.1186/s42077-023-00379-7
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Authors
Anshuman Anand; Suraj Kumar; Virendra Kumar; Manoj Kumar Giri email orcid ; Praveen Kumar Das; Deepti Sharma
Abstract
Background
The anaesthetic agents can affect the quality of motor-evoked potential intraoperatively as they inhibit synaptic transmission. Intravenous anaesthetics suppress motor-evoked potential lesser than inhalational agents, so total intravenous anaesthesia or a combination of intravenous with minimal inhalational anaesthetic supplementation is used when motor-evoked potential is monitored. Motor-evoked potential can get depressed at high doses of propofol required to maintain surgical depth, hence, adjuvant agents like dexmedetomidine that maintain anaesthetic depth without affecting the motor-evoked potential are often required. This study was a prospective non-randomized and comparative study (quasi-experimental) assigned into two groups of 64 each, labelled as the propofol group (group P) and Propofol + dexmedetomidine group (group PD). The primary objective of our study was to compare the total dose reduction of propofol with the addition of dexmedetomidine and their interference with motor-evoked potential readings. The secondary objective was to assess the hemodynamic changes, changes in amplitude and latency of motor-evoked potential, and complications if any.
Results
The mean total dose of propofol consumed in our study was 502.81 ± 71.01 mg in group propofol( P) and 392.18 ± 59.00 mg in group propofol + dexmedetomidine (PD). Moreover, the mean total dose of propofol (mg) was significantly less used in group PD. Intraoperative hemodynamic stability, no difference in amplitude and latency for motor-evoked potential, and only significant bradycardia in group propofol + dexmedetomidine (PD).
Conclusions
Dexmedetomidine can be successfully used in propofol-based total intravenous anaesthesia for motor-evoked potential monitoring in spine surgeries, but it is better to maintain stable hemodynamics with a significant reduction of the mean dose of propofol.
Keywords
Motor-evoked potential; Dexmedetomidine; propofol; Spine surgeries
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