Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2022
Transurethral electrical stimulation for intraoperative bulbocavernosus reflex monitoring during spine surgery in females.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Hayashi Hironobu, Shinjo Takeaki, Takatani Tsunenori, Shigematsu Hideki, Uemura Keiko, Oi Ayako, Kawasaki Sachiko, Kawaguchi Masahiko
Аннотация
OBJECTIVE: Intraoperative bulbocavernosus reflex (BCR) monitoring is more difficult in females than in males. This study was designed to compare the feasibility of transurethral electrical stimulation BCR (tu-BCR) monitoring with that of conventional BCR (c-BCR) monitoring during spine surgery in females.
METHODS: Twenty-four females were included. For stimulation in c-BCR monitoring, a pair of surface electrodes was placed on the genitals (cathode/anode: clitoris/adjacent labium). For stimulation in tu-BCR monitoring, a urethral catheter attached to a pair of electrodes was inserted into the urethra. BCRs were recorded from the external anal sphincter after a single train of four stimulation pulses.
RESULTS: There was no postoperative urinary tract injury associated with urethral catheter insertion for tu-BCR. Tu-BCR monitoring had a significantly higher success rate of baseline recording than c-BCR monitoring (87.5% vs 66.7%, respectively, p = 0.028). The specificities of tu-BCR and c-BCR monitoring were 100% and 87.2%, respectively. The sensitivity was not calculated because no patients had postoperative urinary or bowel dysfunction.
CONCLUSIONS: Our data indicate that tu-BCR monitoring improved the success rate of baseline recording and specificity during spine surgery in females.
SIGNIFICANCE: Tu-BCR monitoring was more reliable than c-BCR monitoring during spine surgery in females.
METHODS: Twenty-four females were included. For stimulation in c-BCR monitoring, a pair of surface electrodes was placed on the genitals (cathode/anode: clitoris/adjacent labium). For stimulation in tu-BCR monitoring, a urethral catheter attached to a pair of electrodes was inserted into the urethra. BCRs were recorded from the external anal sphincter after a single train of four stimulation pulses.
RESULTS: There was no postoperative urinary tract injury associated with urethral catheter insertion for tu-BCR. Tu-BCR monitoring had a significantly higher success rate of baseline recording than c-BCR monitoring (87.5% vs 66.7%, respectively, p = 0.028). The specificities of tu-BCR and c-BCR monitoring were 100% and 87.2%, respectively. The sensitivity was not calculated because no patients had postoperative urinary or bowel dysfunction.
CONCLUSIONS: Our data indicate that tu-BCR monitoring improved the success rate of baseline recording and specificity during spine surgery in females.
SIGNIFICANCE: Tu-BCR monitoring was more reliable than c-BCR monitoring during spine surgery in females.