• Yuu Tanaka, Masahiko Kawaguchi, Yoshinori Noguchi, Kenji Yoshitani, Mikito Kawamata, Kenichi Masui, Takeo Nakayama, and Yoshitugu Yamada.
• Department of Anesthesiology, Nara Medical University, 840 shijo-cho, Kashihara, Nara, 634-8522, Japan. tanakayuu717@gmail.com.
• J Anesth. 2016 Dec 1; 30 (6): 1037-1050.

AbstractMotor evoked potential (MEP) monitoring has been used to prevent neurological complications such as paraplegia in patients who underwent thoracic or thoracoabdominal aortic aneurysm (TAA/TAAA) surgery. The object of this study was making a systematic review to survey the performance of MEP monitoring during TAA/TAAA open repair surgery. We searched electronic databases for relevant studies. We summarized the diagnostic data with summary sensitivity, summary specificity and forest plots of pooled sensitivity, and conducted sub-group analysis. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. We also surveyed the reporting rate of clinical key factors such as methods of anesthesia, surgery, and success rate of MEP. Nineteen studies met our criteria. The results of meta-analysis showed 89.1 % summary sensitivity (95 % confidence interval 47.9-98.6 %) and 99.3 % summary specificity (95 % confidence interval 96.1-99.9 %). Sub-group analysis of pooled sensitivity and specificity by all-or-none cut-off point were better than other cut-off points. The results of the QUADAS-2 were not good. The performance of MEP monitoring was good for detecting postoperative paraplegia in TAA/TAAA open repair surgery. The cut-off point of all-or-none may be the best, according to our review.

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