...is unique, and we tailor our modalities and anesthesia recommendations according to the procedures undertaken and the surgeon's requests.
Inhaled anesthetic obliterates SSEPs and MEPs due to their mode of action, which hinders the transmission of electrical impulses across a synapse. In order for accuracy in MEPs, EMGs, and tEMGs, we request that the patient not be relaxed at the time of recording and that inhaled anesthetic is avoided during the procedure.
If TIVA is for some reason not possible, we will request this protocol, which should allow for accurate neurological responses to SSEPs, MEPs, EMGs, and tEMGs. Nitrous Oxide enhances the effect of the other inhaled anesthesia, therefore obliterating neurological responses for SSEPs and MEPs, and we prefer it to not be used.
If the procedure only requires EMGs or tEMGs, we request short acting paralytic with no requests pertaining to inhaled anesthetic.