Somatosensory Evoked Potentials suppression due to remifentanil during spinal operations; a prospective clinical study

<p>Abstract</p> <p>Background</p> <p>Somatosensory evoked potentials (SSEP) are being used for the investigation and monitoring of the integrity of neural pathways during surgical procedures. Intraoperative neurophysiologic monitoring is affected by the type of anesthetic agents. Remifentanil is supposed to produce minimal or no changes in SSEP amplitude and latency. This study aims to investigate whether high doses of remifentanil influence the SSEP during spinal surgery under total intravenous anesthesia.</p> <p>Methods</p> <p>Ten patients underwent spinal surgery. Anesthesia was induced with propofol (2 mg/Kg), fentanyl (2 mcg/Kg) and a single dose of cis-atracurium (0.15 mg/Kg), followed by infusion of 0.8 mcg/kg/min of remifentanil and propofol (30-50 mcg/kg/min). The depth of anesthesia was monitored by Bispectral Index (BIS) and an adequate level (40-50) of anesthesia was maintained. Somatosensory evoked potentials (SSEPs) were recorded intraoperatively from the tibial nerve (P37) 15 min before initiation of remifentanil infusion. Data were analysed over that period.</p> <p>Results</p> <p>Remifentanil induced prolongation of the tibial SSEP latency which however was not significant (p > 0.05). The suppression of the amplitude was significant (p < 0.001), varying from 20-80% with this decrease being time related.</p> <p>Conclusion</p> <p>Remifentanil in high doses induces significant changes in SSEP components that should be taken under consideration during intraoperative neuromonitoring.</p

Large-scale cross-societal examination of real- and minimal-group biases

Biases in favor of culturally prevalent social ingroups are ubiquitous, but random assignment to arbitrary experimentally created social groups is also sufficient to create ingroup biases (i.e., the minimal group effect; MGE). The extent to which ingroup bias arises from specific social contexts versus more general psychological tendencies remains unclear. This registered report focuses on three questions. First, how culturally prevalent is the MGE? Second, how do critical cultural and individual factors moderate its strength? Third, does the MGE meaningfully relate to culturally salient real-world ingroup biases? We compare the MGE to bias in favor of a family member (first cousin) and a national ingroup member. We propose to recruit a sample of &amp;gt; 200 participants in each of &amp;gt; 50 nations to examine these questions and advance our understanding of the psychological foundations and cultural prevalence of ingroup bias