Thoracoabdominal aortic aneurysms (TAAAs) have a dismal natural history that frequently necessitates surgical repair, but such repairs sometimes result in paraplegia and paraparesis. To reduce the risk of these complications, intraoperative monitoring of spinal cord motor evoked potentials (MEPs) can be used to guide TAAA repair procedures and may potentially minimize spinal cord ischemia. However, the use of MEP monitoring techniques requires important changes to anesthetic management, entails certain risks, and has important contraindications.
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