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

18 Citations (Scopus)

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 - 1994

Fingerprint

Motor Evoked Potentials
Neuromuscular Blockade
Microcomputers
Muscles
Spinal Cord Ischemia
Physiologic Monitoring
Intraoperative Monitoring
Muscle Relaxation
Spinal Cord
Sensitivity and Specificity

Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A computer-controlled, closed-loop infusion system for infusing muscle relaxants : Its use during motor-evoked potential monitoring. / Stinson, Lawrence W.; Murray, Michael J.; Jones, Keith A.; Assef, Saied J.; Burke, Michael J.; Behrens, Terrence L.; Lennon, Robert L.

In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 8, No. 1, 1994, p. 40-44.

Research output: Contribution to journalArticle

Stinson, Lawrence W. ; Murray, Michael J. ; Jones, Keith A. ; Assef, Saied J. ; Burke, Michael J. ; Behrens, Terrence L. ; Lennon, Robert L. / A computer-controlled, closed-loop infusion system for infusing muscle relaxants : Its use during motor-evoked potential monitoring. In: Journal of Cardiothoracic and Vascular Anesthesia. 1994 ; Vol. 8, No. 1. pp. 40-44.
@article{d984db7f9f8f4fc59798e67ec27737cd,
title = "A computer-controlled, closed-loop infusion system for infusing muscle relaxants: Its use during motor-evoked potential monitoring",
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.",
keywords = "descending thoracic aortic aneurysm, postoperative paraplegia, thorscoabdominal aortic aneurysm",
author = "Stinson, {Lawrence W.} and Murray, {Michael J.} and Jones, {Keith A.} and Assef, {Saied J.} and Burke, {Michael J.} and Behrens, {Terrence L.} and Lennon, {Robert L.}",
year = "1994",
doi = "10.1016/1053-0770(94)90010-8",
language = "English (US)",
volume = "8",
pages = "40--44",
journal = "Journal of Cardiothoracic and Vascular Anesthesia",
issn = "1053-0770",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - A computer-controlled, closed-loop infusion system for infusing muscle relaxants

T2 - Its use during motor-evoked potential monitoring

AU - Stinson, Lawrence W.

AU - Murray, Michael J.

AU - Jones, Keith A.

AU - Assef, Saied J.

AU - Burke, Michael J.

AU - Behrens, Terrence L.

AU - Lennon, Robert L.

PY - 1994

Y1 - 1994

N2 - 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.

AB - 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.

KW - descending thoracic aortic aneurysm

KW - postoperative paraplegia

KW - thorscoabdominal aortic aneurysm

UR - http://www.scopus.com/inward/record.url?scp=0027976838&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027976838&partnerID=8YFLogxK

U2 - 10.1016/1053-0770(94)90010-8

DO - 10.1016/1053-0770(94)90010-8

M3 - Article

C2 - 7909456

AN - SCOPUS:0027976838

VL - 8

SP - 40

EP - 44

JO - Journal of Cardiothoracic and Vascular Anesthesia

JF - Journal of Cardiothoracic and Vascular Anesthesia

SN - 1053-0770

IS - 1

ER -