A Comparative Study of the Effect of Propofol Infusion Versus the Combination of Ketamine and Dexmedetomidine Infusion on the Amplitude of Motor Evoked Potential in Pediatrics Undergoing Tethered Spinal Cord Surgeries a Randomized, Double-blinded Controlled Study

N-83-2022

The tethered spinal cord is a common pathology in pediatric neurosurgery. Intraoperative neurophysiologic monitoring (IOM) has gained popularity over the past two decades as a clinical discipline that uses neurophysiologic techniques to detect and prevent iatrogenic neurologic injuries. IOM techniques are extensively used in adult neurosurgery and, in their principles, can be applied to the pediatric population. Inhalational agents cause a dose-dependent reduction in MEPs and are arguably considered incompatible with effective neurophysiological monitoring(5) For this reason, total intravenous anesthesia (TIVA), using IV anesthetics (propofol or ketamine) and opioids (fentanyl or remifentanil), is commonly used in spinal surgeries under MEPs monitoring

2022-10-30

2023-03-20

2023-04-10

Completed

Early phase I

46

Inclusion Criteria: * children with ASA I and II presented to Abu elreesh hospital for untethered spinal cord surgery. Exclusion Criteria: * Children with neuromuscular diseases or congenital scoliosis. * Children with growing rod distraction surgery. * Children with American Society of Anaesthesiologists (ASA) physical status III, IV * Children with preoperative use of antidepressant or anticonvulsant medications. * Children with a known history of drug allergies.

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2024-02-07