A computer-controlled, closed-loop infusion system for infusing muscle relaxants: Its use during motor-evoked potential monitoring

Lawrence W. Stinson, Michael J. Murray, Keith A. Jones, Saied J. Assef, Michael J. Burke, Terrence L. Behrens, Robert L. Lennon

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

A microcomputer-controlled closed-loop infusion system (MCCLIS) has been developed that provides stable intraoperative levels of partial neuromuscular blockade. Complete neuromuscular blockade interferes with intraoperative motorevoked potential (MEP) monitoring used for patients undergoing surgical procedures that place them at risk for spinal cord ischemia. Nine patients were studied during which the MCCLIS maintained stable levels of partial neuromuscular blockade and allowed transcranial magnetic motor-evoked potential (TcM-MEP) monitoring during thoracoabdominal aortic aneurysmectomy. The use of TcM-MEP for monitoring intraoperative spinal cord function was balanced against surgical considerations for muscle relaxation with 80% to 90% neuromuscular blockade fulfilling each requirement. Intraoperative adjustment of partial neuromuscular blockade to facilitate TcM-MEP monitoring was also possible with the MCCLIS. The MCCLIS should allow for further investigation into the sensitivity, specificity, and predictability of TcM-MEP monitoring for any patient at risk for intraoperative spinal cord ischemia including those undergoing thoracoobdominal aortic aneurysmectomy.

Original languageEnglish (US)
Pages (from-to)40-44
Number of pages5
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume8
Issue number1
DOIs
StatePublished - Feb 1994

Keywords

  • descending thoracic aortic aneurysm
  • postoperative paraplegia
  • thorscoabdominal aortic aneurysm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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