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BJA Advance Access published online on October 1, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh284
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted August 15, 2004

Short Communication

Intravenous anaesthesia and repetitive transcranial magnetic stimulation monitoring in spinal column surgery

S. J. Hargreaves 1 and J. W. H. Watt 1*

1 Spinal Injuries Unit, Southport and Ormskirk Hospital NHS Trust, Town Lane, Southport PR8 6PN, UK

* To whom correspondence should be addressed. E-mail: John.Watt{at}southportandormskirk.nhs.uk.


  Abstract

Background. Transcranial magnetic stimulation with motor evoked potential monitoring is a non-invasive method for monitoring motor tracts during surgery. However, anaesthetic agents such as propofol and volatile agents reduce responses to single transcranial magnetic stimulation. We assessed an intravenous technique for anaesthesia to allow motor evoked potentials (MEPs) to be monitored using repetitive transcranial magnetic stimulation (rTMS).

Methods. We applied three-pulse rTMS (TriStim) in 11 patients undergoing spinal column surgery after spinal column injury and recorded the latency and peak-to-peak amplitude of MEPs. Anaesthesia was maintained with propofol and remifentanil.

Results. MEPs were monitored successfully intraoperatively in all patients.

Conclusions. It is possible to monitor intraoperative MEP using rTMS during anaesthesia with propofol and remifentanil.

Keywords: anaesthetics i.v., propofol; analgesics opioid, remifentanil; monitoring, spinal.
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