Total intravenous anaesthesia to facilitate bulbocavernous reflex in a 2-year-old child with tethered cord syndrome: A case report

Abstract

Tethered cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal canal. Intraoperative neurophysiological monitoring like somatosensory evoked potentials and transcranial motor evoked potentials can preclude surgically induced lesions to the nervous system and has become standard of care for many neurosurgical procedures. Despite the potential advantages of total intravenous anaesthesia, it is not a widely used anaesthetic technique in children. Recently, a few case reports have been published regarding the presence of metabolic acidosis even with a short term infusion of propofol. We present a case report in which total intravenous anaesthesia was used to facilitate BCR in a 2-year-old child, to monitor the functional integrity of the sacral reflex, which enables bladder and bowel function.