The purpose of this study is to determine the effect of lidocaine infusion on intraoperative neuromonitoring in patients undergoing spine surgery.
The investigators will compare the stimulation threshold for motor evoked potentials (MEPs) for patients undergoing spine surgery with intraoperative neurophysiologic monitoring (IONM) who receive a lidocaine infusion vs. normal saline (NS) infusion. The endpoint for this objective will be the final stimulation threshold for MEPs at the end of the surgery. The stimulation threshold for MEPs is a commonly used metric to determine the effects of anesthetic agents on MEP signals. Secondary objectives will somatosensory evoked potentials (SSEPs) with an endpoint of amplitude and latency of SSEPs throughout the surgery. Other secondary outcomes will include, intraoperative mean arterial pressure (MAP), intraoperative propofol consumptions, and post-operative visual analog scale (VAS) and opioid consumption.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
44
Lidocaine infusion 1.5 mg/kg/hr
Normal saline infusion
Dartmouth Hitchcock Medical Center
Lebanon, New Hampshire, United States
Motor Evoked Potentials (MEPs)
An endpoint of the final stimulation threshold for MEPs at the end of surgery.
Time frame: Duration of the surgical procedure, no more than 24 hours
Somatosensory Evoked Potentials (SSEPs)
Endpoints of amplitude and latency throughout the surgery of SSEPs
Time frame: Duration of the surgical procedure, no more than 24 hours
Mean Arterial Pressure (MAP)
Intraoperative incidence of MAP \<65 mmHg and MAP \< 55 mmHg
Time frame: Duration of the surgical procedure, no more than 24 hours
Intraoperative propofol consumption
Rate of propofol consumption between the arms
Time frame: Duration of the surgical procedure, no more than 24 hours
Visual Analog Scale (VAS) Pain Scores
Endpoint of VAS pain scores post operative days (POD) 0/1/3
Time frame: Post-operative day 0 through 3
Opiod consumption
Opiod consumption converted to morphine equivalents through post operative day (POD) 3
Time frame: Post-operative day 0 through 3
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