Successful intraoperative management in a patient with decreased motor evoked potential during thoracoabdominal aortic surgery

Abstract

　A 37-year-old male underwent elective thoracoabdominal aortic surgery for chronic aortic dissection. After aortic cross-clamping, there was an immediate decrease in amplitude of motor-evoked potential (MEP). Comprehensive management for increasing spinal cord blood flow resulted in prompt recovery of the MEPs within ten minutes. There was no postoperative neurological deficit. The multimodal treatment, including appropriate blood transfusion, adequate blood pressure control and selective intercostal artery reimplantation, was effective to recover the amplitude of MEPs and not to induce the neurological damage.