SSEPs1.Themostcommonneurophysiologicalmethodformonitoringtheintra-operativespinalfunctionalintegrity2.ThestimulusappliedtotheperipheralN(tibialorulnar)3.Therecordingelectrodesplaced:cervicalregion,scalp,orepiduralspaceduringsurgery4.Baselinedataobtainedafterskinincision5.ResponsesarerecordedintermittentlyduringsurgeryAreductionintheamplitudeby50%andanincreaseinthelatencyby10%areconsideredsignificant.第23页，共44页，星期日，2025年，2月5日TypicaltracingandL-10SSEPsprovidesanindirectwayofmonitoringadjacentmotorpathwaysbecausemoreacuteimpairmentaffectsfunctionofmanyadjacentpathways,notjusttheposteriorcolumn.However,thiscannotbeguaranteed.2.Thebloodsupplyofthecorticospinalmotortractsdiffersfromthatofthedorsomedialsensorytracts.ItispossibletohavenormalSSEPsrecordingsthroughoutsurgery,buttohaveaparaplegicpatientpostoperatively.第24页，共44页，星期日，2025年，2月5日SatisfactorymonitoringofearlycorticalSSEPsispossiblewith0.5–1.0MACisoflurane,desfluraneandsevoflurane.NitrousoxidepotentiatesthedepressanteffectofvolatileanestheticsIntravenousanestheticsgenerallyaffectSSEPslessthaninhaledanestheticsEtomidateandketamineincreasescorticalSSEPamplitudeClinicallyunimportantchangesinSSEPlatencyandamplitudeaftertheadministrationofopioids麻醉药和SSEPs第25页，共44页，星期日，2025年，2月5日SSEPs监测意义EliminatingN2OfromthebackgroundanesthetichasbeenshowntoimprovecorticalamplitudesufficientlytomakemonitoringmorereliableSSEPlatencywilltake5–8mintostabilizeafterthestepchangesinvolatileanestheticconcentrationAddingetomidate,propofoloropioidsispreferabletobeginningN2OorincreasingvolatileanestheticconcentrationswhenanestheticdepthisinadequateIfavolatileanestheticisneverthelessneededrapidly,sevofluranepermitsfasterSSEPrecoveryafterth