Journal «Angiology and Vascular Surgery» • 

2012 • VOLUME 18 • №3

First experience with monitoring somatosensory and motor evoked potential during operations on the thoracic and thoracoabdominal portions of the aorta

Bokeria L.A., Arakelyan V.S., Shanitsyn I.N., Gamzaev N.R., Papitashvili V.G., Gidasnov N.A., Siradze I.V., Ivanov A.A.

Arterial Pathology Department A.N. Bakulev Scientific Centre for Cardiovascular Surgery under the Russian Academy of Medical Sciences, Russia, Moscow

Specialists in Russia have recently gained vast experience in operations on the thoracic and thoracoabdominal portion of the aorta; however, studying evoked potentials for preventing lesions of the spinal marrow have not been studied in any clinic. The authors report herein their first experience in Russia in studying the function of the marrow during operations on the aorta followed by detailed description of the technique of registering evoked potentials.

From June 2010 to January 2011, specialists of the Arterial Pathology Department of the A.N. Bakulev Scientific Centre for Cardiovascular Surgery under the Russian Academy of Medical Sciences carried out a neurophysiological study in a total of 19 patients during operations for thoracic and thoracoabdominal aortic aneurysms. The somatosensory and motor evoked potentials were studied using an 8-channel neuroenhancer Keypoint (Dantec, Denmark).

The hospital mortality rate in the examined group amounted to 5.2% (1/19). Spinal stroke developed in 2 patients, i.e. in 10.5% (2/19). The alterations in the somatosensory and motor evoked potentials were subdivided into groups according to the morphological classification of Crawford-Cunningham. A further two patients were found to have during operation type III changes in the evoked potentials, with both having developed postoperative spinal stroke.

Thus, the method of intraoperative monitoring of evoked potentials has high sensitivity and specificity and can be included into the protocol of operations on the thoracic and abdominothoracic portion of the aorta. During monitoring of evoked potentials it is necessary to maintain a permanent level of anaesthesia and my-orelaxation with obligatory participation of the neurophysiologist in the operation.

KEY WORDS: evoked potentials, surgery, aortic aneurysm, spinal ischaemia.

P. 146

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