scholarly journals Muscle-evoked Potentials After Electrical Stimulation to the Brain in Patients Undergoing Spinal Surgery are Less Affected by Anesthetic Fade With Constant-voltage Stimulation Than With Constant-current Stimulation

Spine ◽  
2019 ◽  
Vol 44 (21) ◽  
pp. 1492-1498 ◽  
Author(s):  
Masato Tanaka ◽  
Hideki Shigematsu ◽  
Masahiko Kawaguchi ◽  
Hironobu Hayashi ◽  
Tsunenori Takatani ◽  
...  
2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Keisuke Masuda ◽  
Hideki Shigematsu ◽  
Masato Tanaka ◽  
Eiichiro Iwata ◽  
Yusuke Yamamoto ◽  
...  

1986 ◽  
Vol 250 (6) ◽  
pp. R1117-R1122 ◽  
Author(s):  
M. L. Mangiapane ◽  
M. J. Brody

The rat subfornical organ (SFO) is involved in the pressor response to circulating angiotensin II, and recent evidence indicates that SFO electrical stimulation also produces a pressor response. In the present experiments we examined the hemodynamic, neural, and humoral mechanisms that underlie the pressor response to electrical stimulation of the SFO. Rats were anesthetized with urethan and instrumented with femoral arterial catheters and with pulsed Doppler flow probes on the superior mesenteric and renal arteries and on the abdominal aorta. Constant-current stimulation, delivered to the SFO via tungsten microelectrodes, resulted in stimulus-locked frequency-dependent pressor responses and vasoconstriction in all vascular beds tested. The stimulation-evoked increases in vascular resistance were greatest in the mesenteric circulation and least in the renal. Movement of the electrode away from the SFO produced significantly smaller responses. Ganglionic blockade abolished the responses to electrical stimulation, whereas vasopressin blockade significantly attenuated the responses. The responses of baroreceptor-denervated rats were qualitatively similar to but approximately double in magnitude of those of normal rats. We conclude that electrical stimulation of the SFO elicits widespread regional vasoconstriction that is most pronounced in the mesenteric circulation. The sympathetic nervous system appears responsible for these effects, but there may be facilitation of the responses by vasopressin.


2007 ◽  
Vol 6 (5) ◽  
pp. 381-385 ◽  
Author(s):  
Bikash Bose ◽  
Anthony K. Sestokas ◽  
Daniel M. Schwartz

Object The incidence of postoperative C-5 spinal nerve root palsy following decompressive cervical spinal surgery has been reported to be as high as 12% for anterior procedures and 30% for posterior procedures. The present study was conducted to document the prevalence of iatrogenic C-5 nerve root deficit during anterior cervical spinal surgery, as well as to evaluate the sensitivity and specificity of intraoperative transcranial electrical stimulation (TES)–induced motor evoked potentials (MEPs) and spontaneous electromyographic (EMG) activity for identifying evolving C-5 nerve root impairment. Methods The authors conducted a retrospective study of 238 consecutive anterior cervical spinal procedures performed by a single surgeon at Christiana Care Hospital within a 48-month period. Techniques used to monitor spinal nerve root function included TES-induced MEPs and spontaneous EMG activity from deltoid, biceps, triceps, wrist extensor, and hand intrinsic muscles innervated by the C5–T1 spinal nerve roots. Spinal cord function was monitored by recording TES-induced MEPs from upper- and lower-extremity muscles as well as somatosensory evoked potentials from stimulation of the ulnar and posterior tibial nerves. Conclusions Transcranial electrical stimulation–induced MEPs and spontaneous EMG activity offer complementary information about evolving iatrogenic C-5 spinal nerve root impairment during anterior cervical spinal surgery. The TES-induced MEPs provide prognostic information and show increased sensitivity to C-5 deficit compared with spontaneous EMG activity alone. Monitoring of spinal nerve root function using only EMG activity carries a risk of false-negative findings; without timely warning of impending neurological impairment, timely intervention to prevent permanent deficit cannot occur.


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