Delayed response of transcranial myogenic motor-evoked potential monitoring to spinal cord ischemia during repair surgery for descending thoracic aortic aneurysm

• Published in: Journal of anesthesia Vol. 22; no. 3; pp. 304 - 307
• Main Authors: Kakinohana, Manabu, Abe, Masanori, Miyata, Yuji, Oshiro, Masakatsu, Saikawa, Satoko, Arakaki, Katsuya, Kuniyoshi, Yukio, Sugahara, Kazuhiro
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 2008
• Subjects: Anesthesiology; Aortic Aneurysm, Thoracic - surgery; Clinical Report; Critical Care Medicine; Emergency Medicine; Evoked Potentials, Motor; Humans; Intensive; Intraoperative Complications - diagnosis; Male; Medicine; Medicine & Public Health; Middle Aged; Monitoring, Intraoperative - methods; Pain Medicine; Paraplegia - etiology; Spinal Cord Ischemia - complications; Spinal Cord Ischemia - diagnosis; Time Factors; tc-MEP; Spinal cord ischemia; Paraplegia; Aortic surgery
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-008-0633-3

The efficacy of transcranial myogenic motor-evoked potential (tc-MEP) monitoring during thoracic aortic surgery has been the subject of some reports, because tc-MEP monitoring can rapidly reflect changes in spinal cord blood flow during thoracic aortic cross-clamping. In this article, we present a case in which delayed loss of tc-MEP signals was observed after cross-clamping of the descending thoracic aorta. We must be aware that tc-MEPs recorded from the lower extremities can fail to provide rapid detection of spinal cord ischemia in the upper thoracic level after cross-clamping of the descending thoracic aorta.