Comparison of the Effects of Vecuronium and Cisatracurium on Electrophysiologic Monitoring During Neurosurgery

Samsung Medical Center

Status: Completed

Conditions: Spine Tumor; Motor Evoked Potential Monitoring; Brain Tumor; General Anesthesia; Neurosurgery; Cerebral Aneurysm

Treatments: Other: MEP monitoring with continuous infusion of vecuronium during general anesthesia; Other: MEP monitoring with continuous infusion of cisatracurium during general anesthesia

Study type: Interventional

Funder types: Other

Identifiers

NCT01690364

2012-05-090-001

Details and patient eligibility

About

Recently intraoperative motor evoked potential monitoring (MEP) is widely used to reduce neural damage during neurosurgery.

As neuromuscular blockade(NMB) during MEP monitoring decreases the amplitude of MEP, partial NMB is usually maintained during general anesthesia. Continuous infusion of NMB agent is preferred than bolus infusion during MEP monitoring. There are a lot of NMB agents in clinical use. But there have been no reports about the effect of changing NMB agent on efficacy of MEP monitoring.

Therefore, the investigators performed a randomized controlled trial to evaluate the effect of changing NMB agent on the variability of MEP amplitude during neurosurgery.

Full description

Recently intraoperative motor evoked potential monitoring (MEP) is widely used to reduce neural damage during neurosurgery.

As neuromuscular blockade(NMB) during MEP monitoring decreases the amplitude of MEP, partial NMB is usually maintained during general anesthesia. Continuous infusion of NMB agent is preferred than bolus infusion during MEP monitoring. There are a lot of NMB agents in clinical use. But there have been no reports about the effect of changing NMB agent on efficacy of MEP monitoring.

Therefore, the investigators performed a randomized controlled trial to evaluate the effect of changing NMB agent on the variability of MEP amplitude during neurosurgery.

Enrollment: 74 patients

Sex: All

Ages: 20 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients undergoing neurosurgery with intraoperative motor evoked potential monitoring

Exclusion criteria

• Patients who can not undergo motor evoked potential monitoring due to central or peripheral neuromuscular disease (e.g. Cerebral palsy, Myasthenia gravis, Acute spinal injury, neurologic shock)
• Patients with hepatic or renal disease with altered metabolism of vecuronium
• Patients with medication which influence the metabolism of vecuronium (e.g. calcium channel blocker, aminoglycoside antibiotics, Lithium, MgSO4)

Trial design

74 participants in 2 patient groups

Cisatracurium Group

Experimental group

Description:

MEP monitoring with continuous infusion of cisatracurium during general anesthesia

Treatment:

Other: MEP monitoring with continuous infusion of cisatracurium during general anesthesia

Vecuronium Group

Active Comparator group

Description:

MEP monitoring with continuous infusion of vecuronium during general anesthesia

Treatment:

Other: MEP monitoring with continuous infusion of vecuronium during general anesthesia