Abstract
Intraoperative motor evoked potential (MEP) monitoring in spine surgery is useful to assess the functional integrity of the motor pathways. Since neuromuscular blockade suppress the MEP waveform, the effect of neuromuscular blockade administered to facilitate intubation in anesthetic induction should be sufficiently recovered before the commencement of MEP monitoring. Recently, in our hospital, if residual neuromuscular blockade remains at the time of recording the first baseline MEP, the selective relaxant-binding agent sugammadex has been used to reverse neuromuscular blockade prior to initiating MEP monitoring. We retrospectively investigated how often did we use sugammadex for MEP monitoring in our hospital. Additionally, we evaluated the effects of sugammadex administration on the time from neuromuscular blockade administration to the start of baseline MEP recording, as well as the effect on baseline MEP amplitude. Four hundred and seventy-one patients (range 20–96 years old) undergoing spine surgery with MEP monitoring under general anesthesia from 2013 to 2018 were included in this study. The percentage of cases with sugammadex was 59.4% (280 patients), whereas those without sugammadex was 40.6% (191 patients). The time from administration of neuromuscular blockade to the start of baseline MEP recording was significantly shorter and baseline MEP amplitude recorded before the decompression maneuver was significantly higher in the group with sugammadex than in the group without sugammadex. This study suggested that administration of sugammadex to start MEP monitoring would contribute to rapid surgical progress and improved accuracy of MEP recording.
