Motor Evoked Potentials (MEPs) allow for real-time monitoring of the corticospinal tracts during spine surgery. MEPs can be difficult to obtain in patients with cervicothoracic myelopathy. We describe 5 myelopathic patients undergoing spine surgery with insufficient MEPs on a standard propofol-based anesthetic. Conversion to high-dose ketamine (20 mcg/kg/min) with other minimally suppressive agents resulted in signal enhancement in a majority (36 of 63) of muscle groups with adequate anesthesia and minimal adverse effects, although with considerable variability in the durability of this effect. High-dose ketamine appears to be a safe and viable option to attempt to augment poor baseline MEP signals.
No takes yet. Share an insight, caveat, or question.
Andrew E. Schober (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: