{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:55:49Z","timestamp":1778824549027,"version":"3.51.4"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003Total intravenous anesthesia (TIVA) is used during surgery with intraoperative neurophysiological monitoring. Addition of adjuvant may minimize suppression of potentials by reducing doses of propofol. We studied the effect of addition of ketamine or dexmedetomidine to propofol\u2013fentanyl-based TIVA on corticobulbar motor evoked potential (CoMEP) in patients undergoing posterior fossa surgeries.<\/jats:p><jats:p>\n          Materials and Methods\u2003Forty-two patients were assigned to three groups (n\u2009=\u200914 each), Group S\u2014saline, Group D\u2014dexmedetomidine (0.25\u2009\u03bcg\/kg\/h), and Group K\u2014ketamine (0.25\u2009mg\/kg\/h). Patients received propofol and fentanyl infusions along with study drugs. CoMEPs were recorded from muscles innervated by cranial nerves bilaterally at predefined intervals (Tbaseline, T2, T3, T4, and T5). Effect on amplitude and latency of CoMEPs was assessed.<\/jats:p><jats:p>\n          Results\u2003A significant fall in CoMEP amplitude was observed across all analyzed muscles at time T4 and T5 in saline and dexmedetomidine group as compared with ketamine group, p-value less than 0.05. A significant increase in latency was observed at T4 and T5 among groups (p-value, D vs. K\u2009=\u20090.239, D vs. S\u2009=\u20090.123, and K vs. S\u2009=\u20090.001).<\/jats:p><jats:p>\n          Conclusion\u2003Both ketamine and dexmedetomidine provide and allow effective recording of CoMEPs. Ketamine emerges as a better agent especially when prolonged surgical duration is expected as even propofol\u2013fentanyl-based TIVA adversely affects CoMEPs when used for long duration.<\/jats:p>","DOI":"10.1055\/s-0043-1772762","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T23:02:53Z","timestamp":1694646173000},"page":"587-596","source":"Crossref","is-referenced-by-count":2,"title":["Effect of Ketamine and Dexmedetomidine as Adjuvant to Total Intravenous Anesthesia on Intraoperative Cranial Nerve Monitoring in the Patients Undergoing Posterior Fossa Craniotomies\u2014A Randomized Quadruple Blind Placebo-Controlled Study"],"prefix":"10.1055","volume":"18","author":[{"given":"Sharmishtha","family":"Pathak","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, Ansari Nagar, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6350-2903","authenticated-orcid":false,"given":"Priyanka","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashutosh","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konish","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesiology and Critical Care, Medanta, Patna, Bihar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/978-3-7091-9419-5_8","article-title":"Neurophysiological monitoring of cranial nerves during posterior fossa surgery","volume":"64","author":"G Broggi","year":"1995","journal-title":"Acta Neurochir Suppl (Wien)"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.neucli.2007.09.013","article-title":"Monitoring of motor pathways during brain stem surgery: what we have achieved and what we still miss?","volume":"37","author":"F Sala","year":"2007","journal-title":"Neurophysiol Clin"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4103\/2348-0548.124832","article-title":"Anaesthetic considerations for evoked potentials monitoring","volume":"1","author":"P Bithal","year":"2014","journal-title":"J 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Liu","year":"2023","journal-title":"J Neurosurg Anesthesiol"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.31616\/asj.2021.0015","article-title":"Evaluation of the effect of continuous infusion of dexmedetomidine or a subanesthetic dose ketamine on transcranial electrical motor evoked potentials in adult patients undergoing elective spine surgery under total intravenous anesthesia: a randomized con","volume":"16","author":"R Andleeb","year":"2022","journal-title":"Asian Spine J"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"2541","DOI":"10.1152\/jn.00505.2019","article-title":"StartReact effects are dependent on engagement of startle reflex circuits: support for a subcortically mediated initiation pathway","volume":"122","author":"V Smith","year":"2019","journal-title":"J Neurophysiol"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1093\/bja\/aew096","article-title":"Definition, 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