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.