Desflurane as an Effective Anaesthetic Agent for Intra-Operative Neuro-Monitoring in Spine Surgeries

Volume 4 | Issue 1 | April 2023 – September 2023 | page: 20-23 | Meeta Agarwala, Hitesh N Modi, Deep J. Patel


Authors: Meeta Agarwala [1], Hitesh N Modi [1], Deep J. Patel [1]

[1] Department of Anaesthesia, Zydus Hospitals, Ahmedabad, Gujarat, India.
[2] Department of Spine Surgery, Zydus hospital, Ahmedabad, Gujarat, India.

Address of Correspondence

Dr. Meeta Agarwala,
Department of Anaesthesia, Zydus Hospitals, Ahmedabad, Gujarat, India.


Background & Aims: Motor evoked potentials (MEP) have been widely used as intraoperative neuromonitoring in patients undergoing spine surgery to prevent neurological complications. The present study aims to show the significance of 6% desflurane as an effective agent in maintaining anaesthesia at a minimum alveolar concentration (MAC) of 0.8–1.0 in patients undergoing spine surgery with neuromonitoring.
Methods: This retrospective, cohort, single-centre study was conducted between 2016 and 2018. Patients who underwent spinal surgery along with intraoperative neuromonitoring were included. Anaesthesia was given with weight adjusted intravenous propofol (2-3 mg/kg) and maintained with Oxygen and air with inhalation desflurane (6%) with MAC of 0.8-1.0 and Bispectral index of 40-60. The data of MEP signals were collected at baseline, after instrumentation, decompression, and closure. The MEP data were correlated using Spearman correlation test and Wilcoxon rank test with minimum alveolar concentration, mean arterial pressure, temperature and bispectral index at different time intervals. P value <0.05 was considered statistically significant.
Results: A total of 37 patients (26 females and 11 males) were included in the study with the mean of 52.46±12.85 years. There was no statistically significant correlation between the variables at different time intervals. Although, a statistically significant negative correlation was observed between bispectral index and latency after decompression (p=0.006). A significant difference was observed in visual analogue scale and Oswestry disability index before and after procedure (p< 0.001).
Conclusion: Anaesthesia with 6% desflurane in 0.8-1.0 MAC does not alter MEP signals in patients undergoing spinal surgery without any complication and with adequate recovery rate from anaesthesia.
Keywords: Anaesthesia, Desflurane, Motor evoked potentials, Propofol


1. Park J-H, Hyun S-J. Intraoperative neurophysiological monitoring in spinal surgery. World Journal of Clinical Cases: WJCC. 2015;3(9):765.
2. Kunisawa T, Nagata O, Nomura M, et al. A comparison of the absolute amplitude of motor evoked potentials among groups of patients with various concentrations of nitrous oxide. Journal of anesthesia. 2004;18(3):181-4.
3. Nathan N, Tabaraud F, Lacroix F, et al. Influence of propofol concentrations on multipulse transcranial motor evoked potentials. British journal of anaesthesia. 2003;91(4):493-7.
4. Pechstein U, Ceclzich C, Nadstawek J, et al. Transcranial high-frequency repetitive electrical stimulation for recording myogenic motor evoked potentials with the patient under general anesthesia. Neurosurgery. 1996;39(2):335-44.
5. Lieberman JA, Lyon R, Feiner J, et al. The effect of age on motor evoked potentials in children under propofol/isoflurane anesthesia. Anesthesia & Analgesia. 2006;103(2):316-21.
6. Liu H-Y, Zeng H-Y, Cheng H, et al. Comparison of the effects of etomidate and propofol combined with remifentanil and guided by comparable BIS on transcranial electrical motor-evoked potentials during spinal surgery. Journal of neurosurgical anesthesiology. 2012;24(2):133-8.
7. Lo Y-L, Dan Y-F, Tan Y, et al. Intraoperative motor-evoked potential monitoring in scoliosis surgery: comparison of desflurane/nitrous oxide with propofol total intravenous anesthetic regimens. Journal of neurosurgical anesthesiology. 2006;18(3):211-4.
8. Heavner J, Kaye A, Lin BK, et al. Recovery of elderly patients from two or more hours of desflurane or sevoflurane anaesthesia. British journal of anaesthesia. 2003;91(4):502-6.
9. Tachibana S, Hayase T, Osuda M, et al. Recovery of postoperative cognitive function in elderly patients after a long duration of desflurane anesthesia: a pilot study. Journal of anesthesia. 2015;29(4):627-30.
10. Chong CT, Manninen P, Sivanaser V, et al. Direct comparison of the effect of desflurane and sevoflurane on intraoperative motor-evoked potentials monitoring. Journal of neurosurgical anesthesiology. 2014;26(4):306-12.
11. Martin DP, Bhalla T, Thung A, et al. A preliminary study of volatile agents or total intravenous anesthesia for neurophysiological monitoring during posterior spinal fusion in adolescents with idiopathic scoliosis. Spine. 2014;39(22):E1318-E24.
12. Malcharek M, Loeffler S, Schiefer D, et al. Transcranial motor evoked potentials during anesthesia with desflurane versus propofol–a prospective randomized trial. Clinical Neurophysiology. 2015;126(9):1825-32.

How to Cite this Article: Agarwala MS, Modi HN, Patel DJ Desflurane | as an Effective Anaesthetic Agent for Intra- Operative Neuro-Monitoring in Spine Surgeries| Back Bone: The Spine Journal | April 2023- September 2023; 4(1): 20-23 |

(Abstract Text HTML)      (Download PDF)