Abstract:

Objective To investigate the feasibility of monitoring the baseline of motor evoked potentials immediately following tracheal intubation without the administration of muscle relaxants in lumbar spine surgery. Methods A prospective study was conducted at Xuzhou Central Hospital， involving a total of 156 patients who were scheduled for Transforaminal Lumbar Interbody Fusion. These patients were randomly divided into two groups： a control group consisting of 72 cases （33 males and 39 females） and an observation group consisting of 75 cases （37 males and 38 females）. The control group underwent monitoring of motor evoked potentials （TceMEP） baseline after spinal exposure during the operation， while the observation group had immediate monitoring of TceMEP baseline after tracheal intubation without muscle relaxants. Hemodynamic changes， intubation satisfaction， and operation time during tracheal intubation were compared between the two patient groups. Additionally， the baseline success rate， stimulation threshold， sensitivity， and specificity of TceMEP were compared between the two groups. Results There were no significant differences in hemodynamic changes and intubation satisfaction between the two patient groups during tracheal intubation （P > 0.05）. The control group had an intubation time of （6.52 ± 1.22） min， while the observation group had a significantly longer intubation time of （9.44 ± 0.84） min （P < 0.05）. The baseline success rate of TceMEP in the observation group was 100%， with an average stimulation threshold of （225.00 ± 22.13）. In contrast， the control group had a baseline success rate of 84.72% and an average stimulation threshold of （342.01 ± 31.07）V for TceMEP monitoring prior to nailing procedures. The success rate of monitoring TceMEP after nailing in the control group was 93.06%， whereas it reached 100% in the observation group， demonstrating a statistically significant difference between the two groups （P<0.05）. There were no statistically significant differences in sensitivity and specificity between the two groups for TceMEP monitoring results（P>0.05）. Conclusions The success rate of monitoring TceMEP baseline immediately after tracheal intubation without muscle relaxation is higher， with a smaller stimulation threshold. There were no differences in sensitivity and specificity compared to the baseline monitoring of TceMEP after spinal exposure during the operation.

Key words: baseline of motor evoked potentials, intraoperative neurophysiological monitoring, tracheal intubation without muscle relaxants, lumbar spine surgery