Journal of Research & Innovation in Anesthesia

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VOLUME 5 , ISSUE 1 ( January-June, 2020 ) > List of Articles

CASE REPORT

Anesthesia Management for Electrophysiological Neuromonitoring in a Patient of a Spinal Tumor Excision at Lumbar Level: A Case Report

Aparna A Ruparel, Shilpa Kanakam, Raghbirsingh Gehdoo, Shruti Hazari, Azra Z Kakroo, Dhirav H Shah

Keywords : Somatosensory and motor-evoked potential, Spinal tumor, Total intravenous anesthesia

Citation Information : Ruparel AA, Kanakam S, Gehdoo R, Hazari S, Kakroo AZ, Shah DH. Anesthesia Management for Electrophysiological Neuromonitoring in a Patient of a Spinal Tumor Excision at Lumbar Level: A Case Report. Res Inno in Anesth 2020; 5 (1):10-12.

DOI: 10.5005/jp-journals-10049-0068

License: CC BY-NC 4.0

Published Online: 28-01-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

This is a case report of a 40-year-old ASA1 patient posted for intradural extramedullary tumor at the level of the L2–L3 spine. The patient was operated for the same and the tumor was resected. Postoperatively after 36 hours, the patient complained of loss of bladder sensation associated with urinary retention. Surgical, urological, and radiological findings were suggestive of the mass effect (remnant tumor or clot) at the site of the previous surgery. A decision was taken to perform a re-exploration at the site with the use of electrophysiological monitoring including somatosensory evoked potential (SSEP) and motor-evoked potential (MEP). The surgery was performed completely under total intravenous sedation with the use of midazolam, fentanyl, and propofol. The remnant mass was resected and the patient regained sensory functions in the postoperative period. Hence, this case report highlights the use of total intravenous sedation for somatosensory and motor-evoked potential monitoring in major neurosurgeries.


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