In the Journals

Lidocaine seen as useful component for balanced anesthesia during spinal surgery

During multilevel spinal fusion, lidocaine may be used for balanced anesthesia with little impact on the monitoring of motor-evoked potentials and somatosensory-evoked potentials, according to results from a recently published study.

“We demonstrated that intravenous lidocaine, shown by other investigators to reduce postoperative pain and opioid consumption, can be used as a component of balanced anesthesia during complex spine surgery without negatively impacting somatosensory and motor-evoked potential spinal cord monitoring,” Ronald G. Emerson, MD, from the department of neurology at Hospital for Special Surgery, told Healio.com/Orthopedics.

Emerson and colleagues administered propofol at 50 mcg/kg/h and propofol 25 mcg/kg/min and lidocaine in addition to isoflurane, ketamine and diazepam to 40 patients who underwent multilevel posterior spinal fusion. Investigators randomly determined the order of the administration. Motor-evoked potential (MEP) voltage thresholds and somatosensory-evoked potential (SSEP) amplitudes were among the primary outcome measures. Other outcomes included isoflurane concentrations and hemodynamic parameters.

During the two anesthetic treatments, investigators saw no significant within-patient difference among the MEP voltage thresholds and the SSEP amplitudes. Investigators noted no difference between the two groups with regard to the estimated blood loss. – by Monica Jaramillo

 

Disclosures: Emerson reports he owns stock in Allegran, Amgen, Eli Lilly, Johnson & Johnson, Pfizer, Tekla Healthcare, Bristol Meyers Squibb, Thermo Fisher Scientific and General Electric; has private investments in Reach Bionics and is a consultant for Persyst Inc. Please see the full study for a list of all other authors’ relevant financial disclosures.

During multilevel spinal fusion, lidocaine may be used for balanced anesthesia with little impact on the monitoring of motor-evoked potentials and somatosensory-evoked potentials, according to results from a recently published study.

“We demonstrated that intravenous lidocaine, shown by other investigators to reduce postoperative pain and opioid consumption, can be used as a component of balanced anesthesia during complex spine surgery without negatively impacting somatosensory and motor-evoked potential spinal cord monitoring,” Ronald G. Emerson, MD, from the department of neurology at Hospital for Special Surgery, told Healio.com/Orthopedics.

Emerson and colleagues administered propofol at 50 mcg/kg/h and propofol 25 mcg/kg/min and lidocaine in addition to isoflurane, ketamine and diazepam to 40 patients who underwent multilevel posterior spinal fusion. Investigators randomly determined the order of the administration. Motor-evoked potential (MEP) voltage thresholds and somatosensory-evoked potential (SSEP) amplitudes were among the primary outcome measures. Other outcomes included isoflurane concentrations and hemodynamic parameters.

During the two anesthetic treatments, investigators saw no significant within-patient difference among the MEP voltage thresholds and the SSEP amplitudes. Investigators noted no difference between the two groups with regard to the estimated blood loss. – by Monica Jaramillo

 

Disclosures: Emerson reports he owns stock in Allegran, Amgen, Eli Lilly, Johnson & Johnson, Pfizer, Tekla Healthcare, Bristol Meyers Squibb, Thermo Fisher Scientific and General Electric; has private investments in Reach Bionics and is a consultant for Persyst Inc. Please see the full study for a list of all other authors’ relevant financial disclosures.