{"id":"b6e424c4-f881-423b-8798-c3184789c05a","slug":"authors-comments-on-recap-mep-trial","title":"Author’s comments on RECAP-MEP trial","authors":["Sapna Suresh","Ajay Prasad Hrishi","Jithendra Thiruvathra","Ganesh Divakar"],"abstract":"Background: The study compares the effects of rocuronium-sugammadex and cisatracurium on motor-evoked potentials (MEPs). Concerns were raised regarding the absence of a formal nerve conduction study to rule out subclinical neuropathy preoperatively. However, transcranial MEP recordings were obtained from the upper limb, which was normal on clinical examination. Methods: The study included only patients classified as American Society of Anesthesiologists (ASA) physical status I and II. Anesthesia was administered using total intravenous anesthesia (TIVA) with propofol and fentanyl, and the total dose of propofol was documented. The TcMEP potentials of the upper limb were compared, excluding lower limb recordings to focus on the relevant pathology. Results: The study recommends sugammadex for complete reversal of rocuronium, noting that this reversal can lead to sudden, inadvertent patient movement during surgery. This necessitated a higher propofol dose in the sugammadex group compared to the control group. Conclusion: The authors emphasize the importance of adequate propofol dosing during TIVA to mitigate risks associated with the use of sugammadex. They clarify that patients with central nervous system afflictions were not included in the study. Keywords: motor-evoked potentials, rocuronium, sugammadex, cisatracurium, anesthesia, neuromonitoring, ASA physical status","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/neuroanesthesia-and-critical-care.png","publishDate":"2026-02-13T00:00:00.000Z","doi":"10.25259/SNI_1433_2025","categories":["Neuroanesthesia and Critical Care","Original Article"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/b6e424c4-f881-423b-8798-c3184789c05a/pdf"}