Optimal warning criteria for VEP monitoring under general anesthesia when amplitude decreases

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K18302
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Nara Medical University
• Principal Investigator: Uemura Keiko 奈良県立医科大学, 医学部, 助教 (10645873)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 視覚誘発電位 / 術後視機能障害 / 警告基準

Outline of Final Research Achievements

Visual evoked potential (VEP) monitoring is useful for evaluating visual function under general anesthesia and can prevent postoperative visual dysfunction by issuing a warning when the amplitude falls during surgery. Currently, this warning criterion is set at a 50% drop in VEP amplitude based on our experience, but the sensitivity of our data at this criterion was 60%, and it is necessary to set a warning criterion with higher sensitivity.
In this study, we examined the degree of VEP amplitude reduction and the occurrence of postoperative visual dysfunction in neurosurgical procedures with VEP monitoring at our institution in order to establish the optimal warning criteria for VEP amplitude reduction to prevent postoperative visual dysfunction.

Free Research Field

術中神経モニタリング

Academic Significance and Societal Importance of the Research Achievements

視機能は最も重要な感覚のひとつで、術後視機能障害は患者のQOLに関わる重大な問題である。そこで、術後視機能障害のリスクがある手術において、視覚誘発電位(visual evoked potential:VEP)モニタリングで術中リアルタイムに視機能評価を行うことは非常に有用である。しかし、その警告基準に関してこれまできちんと検討されておらず、現在経験上用いているVEP振幅50%低下という警告基準では感度は60%程度であり、術後視機能障害を未然に防ぐには確実性に乏しい。そのため、本研究での最適警告基準の設定は患者の視機能を守り術後QOLを改善するために、学術的・社会的意義が非常に大きいといえる。