{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T03:02:26Z","timestamp":1790650946071,"version":"4.1.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","license":[{"start":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T00:00:00Z","timestamp":1713484800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4,19]]},"abstract":"<jats:p>Motor-evoked potential (MEP) monitoring is commonly used in children. MEP monitoring in infants is difficult due to smaller signals requiring higher stimulation voltages. There is limited information on the effect of different anesthetics on MEP monitoring in this age group. This case series describes the effect of different anesthetic regimens on MEP monitoring in infants. Patients\u2005&lt;1 year of age who underwent spinal surgery with MEP monitoring between February 2022 and July 2023 at a single tertiary care children hospital were reviewed. The motor-evoked potential amplitudes were classified into 4 levels based on the voltage in the upper and lower limbs (none, responded, acceptable, sufficient). \u201cAcceptable\u201d or \u201csufficient\u201d levels were defined as successful monitoring. A total of 19 infants were identified, involving 3 anesthesia regimens: 4\/19 (21.1%) cases were anesthetized with propofol\/remifentanil total intravenous anesthesia (TIVA), 3\/19 (15.8%) with propofol\/remifentanil\/low-dose sevoflurane and another 12\/19 (63.2%) cases who initially received propofol\/remifentanil\/sevoflurane and were converted to propofol\/remifentanil anesthesia intraoperatively. The 4 cases with propofol\/remifentanil showed 20\/32 (62.5%) successful monitoring points. In contrast, 6\/24 (25%) successful points were achieved with propofol\/remifentanil intravenous anesthesia\/0.5 age-adjusted minimum alveolar concentration sevoflurane. In 12 cases converted from propofol\/remifentanil\/low-dose inhalational anesthetics to TIVA alone, successful MEP monitoring points increased from 46\/96 (47.9%) to 81\/96 (84.4%). Adding low-dose inhalation anesthetic to propofol-based TIVA suppresses MEP amplitudes in infants. The optimal anesthetic regimen for infants requires further investigation.<\/jats:p>","DOI":"10.1097\/md.0000000000037552","type":"journal-article","created":{"date-parts":[[2024,4,19]],"date-time":"2024-04-19T18:07:29Z","timestamp":1713550049000},"page":"e37552","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Impact of various anesthetic regimens on motor-evoked potentials in infants undergoing spinal surgery: A case series"],"prefix":"10.1097","volume":"103","author":[{"given":"Hirofumi","family":"Nakahari","sequence":"first","affiliation":[{"name":"Department of Anesthesia, St. Luke\u2019s International Hospital, Tokyo, Japan"},{"name":"Department of Anesthesiology, Aichi Children\u2019s Health and Medical Center, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Aichi Children\u2019s Health and Medical Center, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall C.T.","family":"Wilton","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Starship Children\u2019s Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihiro","family":"Kurimoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Aichi Children\u2019s Health and Medical Center, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7136-9815","authenticated-orcid":false,"given":"Taiki","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Aichi Children\u2019s Health and Medical Center, Aichi, Japan"},{"name":"Division of Comprehensive Pediatric Medicine, Nagoya University Graduate School of Medicine, Aichi, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250503","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/00004691-199805000-00005","article-title":"Anesthetic effects on electrophysiologic recordings.","volume":"15","author":"Sloan","year":"1998","journal-title":"J Clin Neurophysiol"},{"key":"R2-20250503","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/pan.13706","article-title":"A manual propofol infusion regimen for neonates and infants.","volume":"29","author":"Morse","year":"2019","journal-title":"Paediatr Anaesth"},{"key":"R3-20250503","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s00381-009-1023-3","article-title":"Anesthesia and intraoperative neurophysiological monitoring in children.","volume":"26","author":"Sloan","year":"2010","journal-title":"Childs Nerv Syst"},{"key":"R4-20250503","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s00540-019-02698-2","article-title":"A practical guide for anesthetic management during intraoperative motor evoked potential monitoring.","volume":"34","author":"Kawaguchi","year":"2020","journal-title":"J Anesth"},{"key":"R5-20250503","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00004691-200210000-00006","article-title":"Anesthesia for intraoperative neurophysiologic monitoring of the spinal cord.","volume":"19","author":"Sloan","year":"2002","journal-title":"J Clin Neurophysiol"},{"key":"R6-20250503","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/bja\/aeg211","article-title":"\u201cInfluence of propofol concentrations on multipulse transcranial motor evoked potentials.\u201d.","volume":"91","author":"Nathan","year":"2003","journal-title":"Br J Anaesth"},{"key":"R7-20250503","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/ANA.0000000000000157","article-title":"Comparison of the effects of propofol and sevoflurane combined with remifentanil on transcranial electric motor-evoked and somatosensory-evoked potential monitoring during brainstem surgery.","volume":"27","author":"Hern\u00e1ndez-Palaz\u00f3n","year":"2015","journal-title":"J Neurosurg Anesthesiol"},{"key":"R8-20250503","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/00008506-200401000-00008","article-title":"Effects of anesthetic agents and physiologic changes on intraoperative motor evoked potentials.","volume":"16","author":"Lotto","year":"2004","journal-title":"J Neurosurg Anesthesiol"},{"key":"R9-20250503","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s10877-014-9571-9","article-title":"Intraoperative neurophysiological monitoring during spine surgery with total intravenous anesthesia or balanced anesthesia with 3% desflurane.","volume":"29","author":"Sloan","year":"2015","journal-title":"J Clin Monit Comput"},{"key":"R10-20250503","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/ANA.0000000000000041","article-title":"Direct comparison of the effect of desflurane and sevoflurane on intraoperative motor-evoked potentials monitoring.","volume":"26","author":"Chong","year":"2014","journal-title":"J Neurosurg Anesthesiol"},{"key":"R11-20250503","doi-asserted-by":"crossref","first-page":"e14160","DOI":"10.1111\/ijcp.14160","article-title":"Intraoperative neurophysiological monitoring in paediatric neurosurgery.","volume":"75","author":"Bidkar","year":"2021","journal-title":"Int J Clin Pract"},{"key":"R12-20250503","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1097\/WNP.0000000000000523","article-title":"Intraoperative neuromonitoring of motor-evoked potentials in infants undergoing surgery of the spine and spinal cord.","volume":"36","author":"Aydinlar","year":"2019","journal-title":"J Clin Neurophysiol"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000037552","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T00:09:44Z","timestamp":1746317384000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/MD.0000000000037552"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,19]]},"references-count":12,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000037552","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,19]]}}}