caa a22 4500 445373008 CHVBK 20180317142953.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00540-010-1044-9 doi (NATIONALLICENCE)springer-10.1007/s00540-010-1044-9 Assessment of intraoperative motor evoked potentials for predicting postoperative paraplegia in thoracic and thoracoabdominal aortic aneurysm repair [Elektronische Daten] [Toshinori Horiuchi, Masahiko Kawaguchi, Satoki Inoue, Hironobu Hayashi, Ryuichi Abe, Nobuoki Tabayashi, Shigeki Taniguchi, Hitoshi Furuya] Purpose: Monitoring motor evoked potentials (MEPs) has been recognized as a highly reliable method to detect intraoperative spinal cord ischemia (SCI) in aortic repair. However, the data regarding the sensitivity and specificity of MEPs for predicting postoperative paraplegia are limited. We retrospectively assessed the value of intraoperative MEP amplitudes for predicting postoperative paraplegia. Methods: The medical records of 44 patients were reviewed. A train-of-five stimulation was delivered to C3-C4, and MEPs were recorded from the abductor pollicis brevis and the tibialis anterior muscles. The cutoff point for detecting SCI was set at 75% decrease of the baseline MEP. Receiver operating characteristic curves were applied at various cutoff points. Results: Three patients (6.8%) had postoperative paraplegia. The minimum MEP during surgery had 100% sensitivity and 64.9% specificity in predicting paraplegia, and the MEP at the end of surgery had 66.7% sensitivity and 78.0% specificity in predicting paraplegia: only 1 patient, who had borderline paraplegia (right monoparesis), showed a false-negative result. Receiver operating characteristic curves indicated that adequate cutoff points for the minimum MEP during surgery and for the MEP amplitude at the end of surgery were a 75-90% decrease and a 64-75% decrease of the baseline MEP, respectively. Conclusion: Monitoring MEPs had relatively high sensitivity and acceptable specificity, with the cutoff point set at 75% decrease of the baseline MEP, for predicting paraplegia and paraparesis. Because of the small sample in our study, further investigations would be necessary to investigate an adequate cutoff point that could predict postoperative paraplegia. Japanese Society of Anesthesiologists, 2010 Motor evoked potentials nationallicence Thoracic and thoracoabdominal aortic aneurysm nationallicence Paraplegia nationallicence Sensitivity nationallicence Specificity nationallicence Horiuchi Toshinori Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut Kawaguchi Masahiko Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut Inoue Satoki Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut Hayashi Hironobu Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut Abe Ryuichi Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut Tabayashi Nobuoki Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Kashihara, Japan aut Taniguchi Shigeki Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Kashihara, Japan aut Furuya Hitoshi Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut Journal of Anesthesia Springer Japan 25/1(2011-02-01), 18-28 0913-8668 25:1<18 2011 25 540 https://doi.org/10.1007/s00540-010-1044-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-010-1044-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Horiuchi Toshinori Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut NATIONALLICENCE 700 1- Kawaguchi Masahiko Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut NATIONALLICENCE 700 1- Inoue Satoki Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut NATIONALLICENCE 700 1- Hayashi Hironobu Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut NATIONALLICENCE 700 1- Abe Ryuichi Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut NATIONALLICENCE 700 1- Tabayashi Nobuoki Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Kashihara, Japan aut NATIONALLICENCE 700 1- Taniguchi Shigeki Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Kashihara, Japan aut NATIONALLICENCE 700 1- Furuya Hitoshi Department of Anesthesiology, Nara Medical University, 840 Shijo-Cho, 634-8522, Nara, Kashihara, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/1(2011-02-01), 18-28 0913-8668 25:1<18 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer