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British Journal of Anaesthesia, Vol 76, Issue 6 870-871, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia

SHORT COMMUNICATIONS

Total i.v. anaesthesia for transcranial magnetic evoked potential spinal cord monitoring

JWH. Watt, M. H. Fraser, B. M. Soni, P. K. Sett and R. Clay
Spinal Injuries Unit, Southport and Formby NHS Trust Hospital, Town Lane, Southport, Merseyside PR8 6PN

Continuous intraoperative monitoring of transcranial magnetic motor evoked potentials (TcMMEP) can warn the surgeon of motor tract damage more effectively than somatosensory evoked potentials. As a non- invasive technique it is especially useful during post-traumatic internal fixation and is applicable whatever the level of the spinal cord at risk. Inhalation and many i.v. anaesthetics block the single pulse TcMMEP but a total i.v. anaesthetic regimen based on methohexitone, alfentanil and ketamine was effective in seven patients undergoing post-traumatic internal fixation. Consistent TcMMEP of 100- 1000 mcV were obtained in all patients, with a latency change of only 2 ms above preoperative values. Good cardiovascular stability was maintained during operation.
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