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Journal of Clinical Monitoring and Computing

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31.07.2020 | Original Research

Motor evoked potential monitoring can evaluate ischemic tolerance to carotid artery occlusion during surgery

verfasst von: Yoshiaki Takamura, Yasushi Motoyama, Tsunenori Takatani, Yasuhiro Takeshima, Ryosuke Matsuda, Kentaro Tamura, Shuichi Yamada, Fumihiko Nishimura, Ichiro Nakagawa, Young-Su Park, Hiroyuki Nakase

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 5/2021

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Abstract

Balloon test occlusion (BTO) is a useful examination for evaluating ischemic tolerance to internal carotid artery (ICA) occlusion. The aim of this study was to investigate the relationships between intraoperative motor evoked potential (MEP) monitoring and the results of preoperative BTO. Between 2013 and 2017, 32 patients undergoing surgery under general anesthesia with intraoperative MEP monitoring, in whom preoperative BTO was performed, were identified. A receiver operator characteristic (ROC) analysis was performed to determine the appropriate cutoff value of MEP amplitude for BTO-positive. Furthermore, the accuracy of MEP monitoring for BTO-positive was compared with electroencephalogram (EEG) and somatosensory evoked potential (SEP) monitoring. Four of 32 (12.5%) patients were BTO-positive. The cutoff value of MEP amplitude for BTO-positive was a > 80% reduction from the baseline level, which showed sensitivity of 100% and specificity of 100%. Thus, the sensitivity and specificity for BTO-positive were significantly higher for MEP than for EEG (100% and 72.0%, p = 0.02) in 28 patients, but they were not significantly different compared with SEP (33.3% and 100%, p = 0.48) in 21 patients. MEP monitoring might be one of the alternatives for evaluating ischemic tolerance to ICA occlusion during surgery. The cutoff value of MEP amplitude was a > 80% reduction.

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Titel: Motor evoked potential monitoring can evaluate ischemic tolerance to carotid artery occlusion during surgery
verfasst von: Yoshiaki Takamura
Yasushi Motoyama
Tsunenori Takatani
Yasuhiro Takeshima
Ryosuke Matsuda
Kentaro Tamura
Shuichi Yamada
Fumihiko Nishimura
Ichiro Nakagawa
Young-Su Park
Hiroyuki Nakase
Publikationsdatum: 31.07.2020
Verlag: Springer Netherlands
Erschienen in: Journal of Clinical Monitoring and Computing / Ausgabe 5/2021
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-020-00573-0

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