Evaluating the Use of 0.5 and 0.75 MAC Desflurane in Patients Undergoing Spinal Surgery
Status:
Recruiting
Trial end date:
2022-11-30
Target enrollment:
Participant gender:
Summary
Background: Somatosensory- (SSEPs) and motor-evoked potentials (MEPs) are commonly used as an
intraoperative neurophysiologic monitoring tool to detect aberrations to the spinal cord
integrity during spinal surgery. Inhalational anaesthetic agents have a significant influence
on evoked potentials by suppressing the amplitude and prolonging the latency. Evidences
suggest that total intravenous anaesthesia (TIVA) is superior to inhalation anaesthesia for
neuromonitoring in spinal surgery, and support the use of up to 0.5 minimum alveolar
concentration (MAC) of inhalational anaesthetic agents in these procedures.
Methods: Patients undergoing spinal surgeries will be prospectively recruited and be induced
with TIVA at baseline of the evoked potentials. They will be randomized to receive balance
anaesthesia with A) Desflurane MAC 0.5+remifentanil, or B) Desflurane MAC 0.75+remifentanil
until the end of surgery. Influence of 1.0 MAC desflurane on the evoked potentials after the
completion of surgery will also be studied.
Desired Results: Endpoints include the changes to the amplitude and latency of SSEPs and MEPs
with 0.5 and 0.75 MAC desflurane. The findings will indicate the safety of desflurane at the
studied concentrations for spinal surgeries, and substantial savings with the use of
desflurane instead of TIVA.