Abstract: Objective To explore the effect of sugammadex on safety indicators such as body movement, choking, peak airway pressure during spinal surgery with motor evoked potential monitoring. Methods This study was a retrospective analysis of two randomized controlled trials. Patients undergoing selective thoracic and lumbar spinal surgery with intraoperative motor evoked potential monitoring were included. Rocuronium was continuously infused and the train-of-four stimulation count was maintained at 2. When motor evoked potential monitoring started, stop rocuronium infusion and 2 mg/kg of sugammadex was given. Indicators were compared between administration of sugammadex and 5, 10, 20, 30,60 minutes after administration like body movement, choking, peak airway pressure, allergic reaction, mean arterial pressure, heart rate, end expiratory pressure of CO₂ and the train-of-four stimulation ratio(TOFr). Results A total of 120 patients were finally included in the analysis. Before administering sugammadex, TOFr was 0.2. At 5, 10, 20, 30 and 60 minutes after administration, TOFr were 0.8, 0.8, 0.9, 0.9, 0.9 respectively. No patient experienced intraoperative body movement, choking, or allergy reaction. Compared with the time of sugammadex administration, heart rate was significantly reduced 5, 10, 20, 30 and 60 minutes after administration (P＜0.05), there was no significant change in the remaining indicators. Conclusions Sugammadex can be safely used during spinal surgery with motor evoked potential monitoring.

Key words: spinal surgery, neurological monitoring, motor evoked potential, sugammadex