Intra-op neuro-monitoring

If the resection area involves or is adjacent to the somatosensory or motor cortex then monitoring of somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) may be required. A TIVA technique is preferable in this case to minimise interference with monitoring

If MEPs are monitored then the muscles of mastication will be activated. A reinforced tracheal tube should be used, and care must be taken to place an appropriately sized bite block between the molars ensuring that the tongue and cheeks are free.

References

Anaesthesia for Epilepsy Surgery