Effects of Adjunct Analgesics and Novel Anesthetic Agents on Intraoperative Neuromonitoring: A Scoping Review
Authors' conclusion
The effects of novel anesthetic and adjunct analgesic agents on IONM are variable and dose-dependent, necessitating individualized anesthetic strategies.
Study context
- Population
- Intraoperative neuromonitoring (SSEPs and motor evoked potentials (MEPs)) with novel anesthetic and adjunct analgesic agents (lidocaine, ketamine, dexmedetomidine, methadone, magnesium, gabapentinoids, xenon, remimazolam)53 studies
- Outcome
- Effects on somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs)
Methodological detailsbackward citation searching, Search of Medline, Cochrane Central, CINAHL, Scopus, LILACS and Embase from inception to February 2025
- Backward citation searching
- Search of Medline, Cochrane Central, CINAHL, Scopus, LILACS and Embase from inception to February 2025
Main finding
As reported in the abstract
- Lidocaine within analgesic dosing: minimal impact on SSEPs and MEPs
- Ketamine: augmentative, neutral or suppressive effects, apparently dose-regimen dependent
- Dexmedetomidine: mixed effects, potentially due to dose-dependent hemodynamic alterations and pharmacokinetics
- Methadone and magnesium: minimal impact
- Xenon: clinically relevant suppression of evoked potentials
- Remimazolam: neuromonitoring integrity maintained at clinically relevant doses
- 30 randomized and 23 nonrandomized studies
Original publication
Effects of Adjunct Analgesics and Novel Anesthetic Agents on Intraoperative Neuromonitoring: A Scoping Review. Anesth Analg. Published 25 November 2025. doi:10.
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