Comparison of IONM Between Remimazolam and Propofol
Status:
Recruiting
Trial end date:
2022-06-30
Target enrollment:
Participant gender:
Summary
Inhalation anesthetics significantly can delay latency and reduce amplitude of cortical MEPs
and SSEPs signals compared to intravenous anesthetics by acting on not only GABA
(γ-aminobutyric acid) receptors but also NMDA (N-methyl-D-aspartate) receptors, so total
intravenous anesthesia (TIVA) have been more preferred for neurophysiological monitoring
follow-up during surgery. However, just less than inhalation anesthetics, the decrease of
amplitude and the delay of latency also occur according to the dose dependant of propofol.
Moreover, it can cause various adverse effects such as delayed recovery after anesthesia or
propofol infusion syndrome, consequently, combined methods with other agents or conversion to
other relative anesthetics are being made. Remimazolam is a ultra-short-acting
benzodiazepine, and unlike conventional benzodiazepine drugs, it is rapidly metabolized in
plasma and not accumulates in the body for long periods of infusion or even with high dose
administration. Recently, there have been repored that continuous infusion of 0.5-1.5 mg/kg
of remimazolam has little effect on the motor evoked potential (MEPs) of cervical spine
surgery patients, but this is a case report without the control group; further prospective
studies are definitely needed. Therefore, in the case of using propofol or remimazolam for
total intravenous anesthesia, we aim to investigate which intravenous anesthetic is more
appropriate for intraoperative neurophysiological monitoring by comparing the results of the
somatosensory evoked potential (SSEPs) and MEPs according to these anesthetics.