Abstract
Intraoperative monitoring of somatosensory evoked potentials (SEP) is used increasingly to improve monitoring of neural tracts at risk during scoliosis surgery, surgical procedures involving the thoracic aorta, or cerebral perfusion such as carotid endarterectomy and intracranial aneurysm surgery. Changes in SEP latency and waveform may indicate impaired transmission in the pathway monitored. In addition to SEP changes due to surgical trauma and cerebral ischemia, SEPs are also modulated by a variety of other factors including drug-induced changes of the evoked electroencephalogram (EEG). The effects of anesthetics on spinal, subcortical, and cortical SEP have been extensively studied over the past 20 years. Anesthetic and sedative agents are known to exert their effects primarily on the association areas in the cortex and second- or third-order neurons involved in sensory signal processing and evaluation of information transmitted by the somatosensory system. Because drug-induced changes in SEP are predictable and appear to be non-agent-specific, the use of SEP monitoring for assessment of depth of anesthesia has been proposed.
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