Erschienen in:
09.09.2016 | Review Article
Systematic review of motor evoked potentials monitoring during thoracic and thoracoabdominal aortic aneurysm open repair surgery: a diagnostic meta-analysis
verfasst von:
Yuu Tanaka, Masahiko Kawaguchi, Yoshinori Noguchi, Kenji Yoshitani, Mikito Kawamata, Kenichi Masui, Takeo Nakayama, Yoshitugu Yamada
Erschienen in:
Journal of Anesthesia
|
Ausgabe 6/2016
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Abstract
Motor evoked potential (MEP) monitoring has been used to prevent neurological complications such as paraplegia in patients who underwent thoracic or thoracoabdominal aortic aneurysm (TAA/TAAA) surgery. The object of this study was making a systematic review to survey the performance of MEP monitoring during TAA/TAAA open repair surgery. We searched electronic databases for relevant studies. We summarized the diagnostic data with summary sensitivity, summary specificity and forest plots of pooled sensitivity, and conducted sub-group analysis. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. We also surveyed the reporting rate of clinical key factors such as methods of anesthesia, surgery, and success rate of MEP. Nineteen studies met our criteria. The results of meta-analysis showed 89.1 % summary sensitivity (95 % confidence interval 47.9–98.6 %) and 99.3 % summary specificity (95 % confidence interval 96.1–99.9 %). Sub-group analysis of pooled sensitivity and specificity by all-or-none cut-off point were better than other cut-off points. The results of the QUADAS-2 were not good. The performance of MEP monitoring was good for detecting postoperative paraplegia in TAA/TAAA open repair surgery. The cut-off point of all-or-none may be the best, according to our review.