Vaughn et al. are to be commended for their excellent educational case report on anesthesia for thoracoabdominal aortic aneurysm repair. However, there is one area that we believe merits clarification because it does not bring "completeness" to a full discussion of the subject. In their report, they tend to minimize the relative value and utility of neu-rophysiologic monitoring during thoracoabdominal aortic aneurysm (TAAA) surgery, while citing a small sample of studies and citing "drawbacks and limitations for the use of somatosensory-evoked potentials (SSEPs) and motor-evoked potentials (MEPs)." One is immediately reminded of the debate on cerebrospinal fluid drainage that raged for many years. As early as 1988, Hollier's group had provided evidence of the neuroprotective action of cerebrospinal fluid drainage in canine studies. ' However, skepticism prevailed among surgeons for many years. Crawford himself was highly skeptical of the modality, stating in 1991, "Thus cerebrospinal fluid drainage as we used it, was not beneficial in preventing paraplegia."4 But, only in 1994, when Safi et al. demonstrated the association between cerebrospinal fluid drainage and reduced postoperative neurologic deficits in TAAA patients, did the surgical community relent.
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