%0 Journal Article
%T Second-degree atrioventricular block induced by electrical stimulation of transcranial motor-evoked potential: a case report.
%A Murakami T
%A Tanaka S
%A Tanaka R
%A Ito M
%A Ishida T
%A Kawamata M
%J JA Clin Rep
%V 10
%N 1
%D 2024 Jun 12
%M 38862743
暂无%R 10.1186/s40981-024-00722-3
%X <B>BACKGROUND: </B>Although several complications of transcranial motor-evoked potentials (Tc-MEPs) have been reported, reports of arrhythmias during Tc-MEP are very rare.<BR><B>METHODS: </B>A 71-year-old woman underwent transforaminal lumbar interbody fusion under general anesthesia, with intraoperative Tc-MEP monitoring. Preoperative electrocardiography showed an incomplete right bundle branch block but no cardiovascular events in her life. After induction of anesthesia, Tc-MEP was recorded prior to the surgery. During the Tc-MEP monitoring, electrocardiography and arterial blood pressure showed a second-degree atrioventricular block, but it improved rapidly at the end of the stimulation, and the patient was hemodynamically stable. Tc-MEP was recorded seven times during surgery; the incidence of P waves without QRS complexes was significantly higher than before stimulation. The surgery was uneventful, and she was discharged eight days postoperatively without complications.<BR><B>CONCLUSIONS: </B>Our case suggests that electrical stimulation for Tc-MEP can cause arrhythmia. Electrocardiography and blood pressure must be closely monitored during Tc-MEP monitoring.