Novel technique of switching TIVA and sevoflurane during epilepsy surgery for combined intraoperative motor evoked potentials monitoring and electrocorticography: an illustrative case report

被引：0

作者：

Mukoyama, Yoko ^{[1
]}

Ichikawa, Junko ^{[1
]}

Komori, Makiko ^{[1
]}

Kodaka, Mitsuharu ^{[1
]}

Yokosako, Suguru ^{[2
]}

Kubota, Yuichi ^{[2
]}

机构：

[1] Tokyo Womens Med Univ, Dept Anesthesiol, Adachi Med Ctr, 4-33-1 Kouhoku,Adachi Ku, Tokyo 1238558, Japan

[2] Tokyo Womens Med Univ, Dept Neurosurg, Adachi Med Ctr, 4-33-1 Kouhoku,Adachi Ku, Tokyo 1238558, Japan

来源：

JA CLINICAL REPORTS | 2024年 / 10卷 / 01期

关键词：

Epilepsy surgery; Neuroanesthesia; Propofol; Sevoflurane; Anesthetic agent switching; Intraoperative neurophysiological monitoring; Motor evoked potentials; Electrocorticography; PROPOFOL;

D O I：

10.1186/s40981-024-00740-1

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

BackgroundDuring epilepsy surgery, it is equally important to record electrocorticography (ECoG) for detecting epileptogenic activity and guiding brain resection, and to evaluate neuromonitoring data, particularly motor evoked potentials (MEP), for avoidance of postoperative neurological complications. However, sevoflurane, which is commonly used during recording of ECoG, may attenuate the MEP response. It enforces anesthesiologists and neurosurgeons to select one anesthetic agent over another, facilitating either ECoG or MEP monitoring.Case presentationIn the presented case of a 20-year-old man, who underwent surgery for temporal lobe epilepsy, a novel technique of neuroanesthesia was introduced, integrating initial induction of the total intravenous anesthesia (TIVA) with propofol (effect-site concentration, 2.3-3.0 mu g/ml), its subsequent switching to sevoflurane (end-tidal concentration, 2.5%) for ECoG recording, and further change back to TIVA for MEP monitoring during brain resection.ConclusionsIntraoperative switch of anesthetic agents according to specific intraoperative requirements may be useful for cases of brain surgery requiring both ECoG recordings and MEP monitoring.

引用

页数：6