ArticleJournal of anesthesia2025
Impact of low-dose sevoflurane with propofol-based anesthesia on motor-evoked potentials in infants: a single-arm crossover pilot study.
Article in Journal of anesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe influence of anesthetic interactions on motor-evoked potentials in infants has rarely been reported. In infants, adding a small dose of sevoflurane to propofol-based total intravenous anesthesia is reasonable for reducing propofol administration. We collected preliminary data regarding the effect of low-dose sevoflurane in propofol-based total intravenous anesthesia on motor-evoked potentials in infants.
methodsThis pilot interventional study included 10 consecutive infants requiring motor-evoked potentials between January 2023 and March 2024. The motor-evoked potential amplitudes in the upper and lower extremities were recorded twice when general anesthesia was maintained using (1) propofol-based total intravenous anesthesia and (2) 0.1-0.15 age-adjusted minimum alveolar concentration sevoflurane + propofol-based total intravenous anesthesia.
resultsThe motor-evoked potential amplitude in the right upper extremity was not significantly different after the addition of a small dose of sevoflurane [192 (75.3-398) μV, 121 (57.7-304) μV, P = 0.19]. All the motor-evoked potential amplitudes in the right lower extremity (quadriceps femoris, anterior tibialis, and gastrocnemius muscles) were significantly attenuated by adding a small dose of sevoflurane (median [interquartile range]: 47.9 [35.4-200] μV, 25.2 [12.4-55.3] μV, P = 0.014; 74.2 [51.9-232] μV, 31.2 [2.7-64] μV, P = 0.0039; 29.8 [20-194] μV, 9.9 [3.8-92.4] μV, P = 0.0039, respectively). Similar results were observed in the left lower extremities.
conclusionAdding even 0.1-0.15 age-adjusted minimum alveolar concentration sevoflurane to propofol-based total intravenous anesthesia attenuated the motor-evoked potential amplitudes in the lower extremities. A further prospective interventional study with an appropriate sample size is required to investigate the study hypothesis.
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