Neuron irritation lies at the heart of intraoperative motor mapping and varies with the general anaesthetic type and dose. Basing on the analysis of 63 cases (male/female 25/38, aged 21–69) of brain tumors (glial tumors, metastasis, cavernous angiomas) the study explores the role of propofol and sevoflurane in the affectability of cortex neurons during the intraoperative neurophysiological mapping. The study has clearly demonstrated that the liminal current strength is notably higher when inhalation anaesthesia (sevoflurane) is used, than in the case of TIVA (propofol). The propofol activity in the doses causing brain activity depression results in a sharp increase in the excitability threshold. In contrast, sevoflurane causes a steady dose-related rise in the liminal current strength during the motor area galvanic stimulation due to the suppression of affectability and conduction in the nervous system.

The results of intraoperative neurophysiological monitoring during neurosurgical treatment of pathological processes in the central nervous system are analyzed. The mechanisms of action of general anesthetics on the excitability of the pyramidal system during anesthesia with propofol and sevoflurane have been clarified. It has been established that anesthetics with different mechanisms differ in their effect on excitability and conductivity in the system motor neuron of the cortex pathways alpha-motor neuron. Inhalation anesthetic sevoflurane causes a slowdown in the conduction of a nerve impulse and a violation of the mechanisms of convergence of excitation on the alpha-motor neuron of the spinal cord. In this regard, during general anesthesia with sevoflurane, in order to achieve the effectiveness of transcranial electrical stimulation, the number of stimuli in the package should be increased first with a relatively high stimulation current. Under general anesthesia with propofol, the processes of convergence of excitation are not inhibited, therefore, effective electrical stimulation is achieved by increasing the stimulation current with a stable number of stimuli. With an increase in doses of general anesthetic to a level at which periodic patterns are recorded on the electroencephalogram, a deep inhibition of the excitability and conductivity of the pyramidal system occurs. Under these conditions, effective performance of transcranial electrical stimulation is achieved with submaximal values of the current strength and the number of stimuli.

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