Hostname: page-component-848d4c4894-cjp7w Total loading time: 0 Render date: 2024-07-06T20:07:47.287Z Has data issue: false hasContentIssue false
  • English
  • Français

Observations on intraoperative monitoring of visual pathways using steady-state visual evoked potentials

Published online by Cambridge University Press:  23 December 2004

H. Wiedemayer ,
B. Fauser ,
I. E. Sandalcioglu ,
W. Armbruster  and
D. Stolke
H. Wiedemayer
Affiliation:
University of Essen, Department of Neurosurgery, Essen, Germany
B. Fauser
Affiliation:
University of Essen, Department of Neurosurgery, Essen, Germany
I. E. Sandalcioglu
Affiliation:
University of Essen, Department of Neurosurgery, Essen, Germany
W. Armbruster
Affiliation:
University of Essen, Department of Anaesthesiology and Intensive Care Medicine, Essen, Germany
D. Stolke
Affiliation:
University of Essen, Department of Neurosurgery, Essen, Germany
Get access

Abstract

Summary

Background and objective: Former studies revealed conflicting information on the usefulness of intraoperative monitoring of visual evoked potentials. This study was designed to evaluate the characteristics of visual evoked potential recording in surgically anaesthetized patients using the modality of steady-state visual evoked potentials.

Methods: In 30 cases with non-cranial surgery steady-state visual evoked potentials were recorded in the awake and surgically anaesthetized patient using total intravenous anaesthesia. For stimulation, goggles with red light-emitting diodes at a frequency of 8.5 Hz were used. A two-channel recording with silver cup electrodes at Oz to Fz and Oz to earlobe was used. All traces were analysed for the presence of the characteristically sinusoidal waveform and amplitudes and latencies of the main peaks were measured.

Results: Recordings during surgery demonstrated a minor latency prolongation of 16% and a more pronounced amplitude attenuation of 67% compared to the recordings in the awake patients. These differences were statistically significant (paired t-test, P < 0.001). In surgically anaesthetized patients steady-state visual evoked potentials showed a relatively high intra- and interindividual variability. In four of 30 patients completely stable recordings were obtained, whereas in 14 patients identifiable waves were recordable in only less than 50% of the intraoperative traces. Of the total 1360 traces recorded intraoperatively clearly identifiable steady-state visual evoked potentials patterns were present in 56% of the traces. There was no correlation between the magnitude of the evoked potential amplitude and its stability in intraoperative recordings.

Conclusions: We conclude from this study, that steady-state visual evoked potential recordings in the surgically anaesthetized patient appeared to be more stable compared to our earlier findings using transient visual evoked potentials. However, further efforts are necessary to improve the stability of the recordings during surgery and thus allow for a more reliable intraoperative monitoring of visual pathways in routine clinical practice.

Keywords

ANAESTHESIA, intravenousEVOKED POTENTIALS, visualINTRAOPERATIVE MONITORING
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 6 , June 2004 , pp. 429 - 433
Copyright
2004 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Handel N, Law J, Hoehn R, Kirsch W. Monitoring visual evoked response during craniofacial surgery. Ann Plast Surg 1979; 2: 257–258.Google Scholar
Harding GF, Bland JD, Smith VH. Visual evoked potential monitoring of optic nerve function during surgery. J Neurol Neurosurg Psychiat 1990; 53: 890–895.Google Scholar
Herzon GD, Zealear DL. Intraoperative monitoring of the visual evoked potential during endoscopic sinus surgery. Otolaryngol Head Neck Surg 1994; 111: 575–579.Google Scholar
Chacko AG, Babu KS, Chandy MJ. Value of visual evoked potential monitoring during trans-sphenoidal pituitary surgery. Br J Neurosurg 1996; 10: 275–278.Google Scholar
Hussain SS, Laljee HC, Horrocks JM, Tec H, Grace AR. Monitoring of intraoperative visual evoked potentials during functional endoscopic sinus surgery (FESS) under general anaesthesia. J Laryngol Otol 1996; 110: 31–36.Google Scholar
Raudzens PA. Intraoperative monitoring of evoked potentials. Ann NY Acad Sci 1982; 388: 308–326.Google Scholar
Nau HE, Hess W, Pohlen G, Marggraf G, Rimpel J. Evoked potentials in intracranial operations: current status and our experiences. Anaesthesist 1987; 36: 116–125.Google Scholar
Cedzich C, Schramm J, Mengedoht CF, Fahlbusch R. Factors that limit the use of flash visual evoked potentials for surgical monitoring. Electroenceph Clin Neurophysiol 1988; 71: 142–145.Google Scholar
Wiedemayer H, Fauser B, Armbruster W, Gasser T, Stolke D. Visual evoked potentials for intraoperative neurophysiologic monitoring using total intravenous anesthesia. J Neurosurg Anesthesiol 2003; 15: 19–24.Google Scholar
Fagan JrJE, Allen RG, Yolton RL. Factors contributing to amplitude variability of the steady-state visual evoked response. Am J Optom Physiol Opt 1984; 61: 453–464.Google Scholar
Fagan JrJE, Downard FG, Yolton RL. Steady-state visual evoked response amplitudes and concurrent electroencephalographic activity. Am J Optom Physiol Opt 1985; 62: 418–422.Google Scholar
Sebel PS, Ingram DA, Flynn PJ, Rutherfoord CF, Rogers H. Evoked potentials during isoflurane anaesthesia. Br J Anaesth 1986; 58: 580–585.Google Scholar
Scheepstra GL, de Lange JJ, Booij LH, Ros HH. Median nerve evoked potentials during propofol anaesthesia. Br J Anaesth 1989; 62: 92–94.Google Scholar
Zentner J, Albrecht T, Heuser D. Propofol increases amplitudes of SEP. Funct Neurol 1991; 6: 411–412.Google Scholar
Taniguchi M, Nadstawek J, Pechstein U, Schramm J. Total intravenous anesthesia for improvement of intraoperative monitoring of somatosensory evoked potentials during aneurysm surgery. Neurosurgery 1992; 31: 891–897.Google Scholar
Wiedemayer H, Fauser B, Sandalcioglu IE, Schafer H, Stolke D. The impact of neurophysiological intraoperative monitoring on surgical decisions: a critical analysis of 423 cases. J Neurosurg 2002; 96: 255–262.Google Scholar
Silberstein RB, Ciorciari J, Pipingas A. Steady-state visually evoked potential topography during the Wisconsin card sorting test. Electroenceph Clin Neurophysiol 1995; 96: 24–35.Google Scholar
Di Russo F, Spinelli D. Electrophysiological evidence for an early attentional mechanism in visual processing in humans. Vision Res 1999; 39 : 2975–2985.Google Scholar
Muller MM, Hillyard S. Concurrent recording of steady-state and transient event-related potentials as indices of visual–spatial selective attention. Clin Neurophysiol 2000; 111: 1544–1552.Google Scholar
Silberstein RB, Line P, Pipingas A, Copolov D, Harris P. Steady-state visually evoked potential topography during the continuous performance task in normal controls and schizophrenia. Clin Neurophysiol 2000; 111: 850–857.Google Scholar
Pigeau RA, Frame AM. Steady-state visual evoked responses in high and low alpha subjects. Electroenceph Clin Neurophysiol 1992; 84: 101–109.Google Scholar
Thompson JC, Tzambazis K, Stough C, Nagata K, Silberstein RB. The effects of nicotine on the 13 Hz steady-state visually evoked potential. Clin Neurophysiol 2000; 111: 1589–1595.Google Scholar
Di Russo F, Spinelli D. Effects of sustained, voluntary attention on amplitude and latency of steady-state visual evoked potential: a costs and benefits analysis. Clin Neurophysiol 2002; 113: 1771–1777.Google Scholar
Munglani R, Andrade J, Sapsford DJ, Baddeley A, Jones JG. A measure of consciousness and memory during isoflurane administration: the coherent frequency. Br J Anaesth 1993; 71: 633–641.Google Scholar