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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3828

Title: Motor evoked potential monitoring can evaluate ischemic tolerance to carotid artery occlusion during surgery.
Other Titles: 術中運動誘発電位モニタリングによる内頚動脈閉塞に対する虚血耐性評価
Authors: Takamura, Yoshiaki
Motoyama, Yasushi
Takatani, Tsunenori
Takeshima, Yasuhiro
Matsuda, Ryosuke
Tamura, Kentaro
Yamada, Shuichi
Nishimura, Fumihiko
Nakagawa, Ichiro
Park, Young-Su
Nakase, Hiroyuki
Keywords: Balloon test occlusion
Carotid artery occlusion
Intraoperative neurophysiological monitoring
Ischemic tolerance
Motor evoked potential
Issue Date: 31-Jul-2020
Publisher: Springer Nature
Citation: Journal of clinical monitoring and computing Online ahead of print (2020 Jul 31)
Abstract: Balloon test occlusion (BTO) is a useful examination for evaluating ischemic tolerance to internal carotid artery (ICA) occlusion. The aim of this study was to investigate the relationships between intraoperative motor evoked potential (MEP) monitoring and the results of preoperative BTO. Between 2013 and 2017, 32 patients undergoing surgery under general anesthesia with intraoperative MEP monitoring, in whom preoperative BTO was performed, were identified. A receiver operator characteristic (ROC) analysis was performed to determine the appropriate cutoff value of MEP amplitude for BTO-positive. Furthermore, the accuracy of MEP monitoring for BTO-positive was compared with electroencephalogram (EEG) and somatosensory evoked potential (SEP) monitoring. Four of 32 (12.5%) patients were BTO-positive. The cutoff value of MEP amplitude for BTO-positive was a > 80% reduction from the baseline level, which showed sensitivity of 100% and specificity of 100%. Thus, the sensitivity and specificity for BTO-positive were significantly higher for MEP than for EEG (100% and 72.0%, p = 0.02) in 28 patients, but they were not significantly different compared with SEP (33.3% and 100%, p = 0.48) in 21 patients. MEP monitoring might be one of the alternatives for evaluating ischemic tolerance to ICA occlusion during surgery. The cutoff value of MEP amplitude was a > 80% reduction.
Description: 博士(医学)・乙第1483号・令和2年12月24日
© Springer Nature B.V. 2020
This is a post-peer-review, pre-copyedit version of an article published in Journal of clinical monitoring and computing. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10877-020-00573-0.
URI: http://hdl.handle.net/10564/3828
ISSN: 13871307
Academic Degrees and number: 24601B1483
Degree-granting date: 2020-12-24
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2020年度

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