Mayo Clinic
The purpose of this research is to compare four commonly used anesthesia medication strategies for placing a breathing tube in patients undergoing spine surgery that requires motor evoked potential (MEP) monitoring.
Specifically, the study will compare two different doses of remifentanil, succinylcholine, and rocuronium followed by sugammadex to determine which approach provides the best conditions for endotracheal intubation while minimizing interference with nerve monitoring. Researchers will also evaluate how these approaches affect blood pressure and heart rate during anesthesia induction, the quality of motor evoked potential monitoring, the need for additional airway interventions or rescue medications, and the occurrence of side effects such as muscle soreness after surgery.
Inclusion Criteria: * American Society of Anesthesiologists (ASA) physical status I-III * Scheduled for elective spine surgery (cervical, thoracic, or lumbar) requiring intraoperative MEP monitoring * Able to provide written informed consent Exclusion Criteria: * Known or suspected difficult airway (Mallampati class IV, history of difficult intubation, limited mouth opening \< 3 cm, limited neck extension) * Body mass index (BMI) \> 40 kg/m2 * Known allergy or hypersensitivity to remifentanil, succinylcholine, rocuronium, sugammadex, or propofol * Personal or family history of malignant hyp…
Remifentanil 2 mcg/kg intravenous bolus
Remifentanil 4 mcg/kg intravenous bolus
Succinylcholine 1 mg/kg intravenous bolus
Rocuronium 0.6 mg/kg intravenous bolus
Sugammadex reversal after intubation
Arctuva estimate
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