Motor Evoked Potential Monitoring in Aortic Surgery

Abstract

Cerebrospinal disorder occurs with a certain frequency in thoracic descending aortic aneurysm surgery and thoracoabdominal aortic aneurysm surgery, with paraplegia being the most serious complication. In surgery where there is a risk that motor dysfunction will occur, it is important to preserve motor function after surgery by monitoring it during surgery. To that end, anesthesia management needs to be able to safely and appropriately record motor evoked potential（MEP）and evaluate its changes. We describe how to evaluate and respond to changes in MEP. In aortic surgery, use of extracorporeal circulation, cross-clamp, and hypothermia, etc. require attention in evaluating MEP. We also outline cerebrospinal fluid drainage, which is one strategy against paralysis. By sharing information on MEP monitoring and cerebrospinal fluid drainage, we aim to contribute to the anesthesia management of spinal cord protection in aortic surgery and to contribute to the improvement of patient prognosis.