Marfan’s syndrome (MFS) is a genetic connective tissue disorder often complicated by severe, progressive scoliosis, posing significant anesthetic and intraoperative monitoring challenges. We report a 12-year-old male with MFS who underwent elective scoliosis correction utilizing somatosensory and motor evoked potential neuromonitoring. During the initial surgery, profound blood loss resulted in hemodynamic instability and a total loss of intraoperative neuromonitoring (IONM) signals, requiring the procedure to be halted. After reviewing anesthetic and surgical factors, the second-stage operation reduced propofol dosing and added low-dose ketamine to enhance hemodynamic and neurophysiological stability. Reliable intraoperative signals were preserved, facilitating safe completion of surgery without postoperative neurological deficits. This case highlights the critical importance of tailored total intravenous anesthesia, meticulous hemodynamic management, and close multidisciplinary communication to ensure IONM fidelity and patient safety in scoliosis correction for MFS patients. Anesthetic adjustments and vigilant monitoring are pivotal for optimal outcomes in complex connective tissue disorderse..
Keywords: Marfan’s syndrome, scoliosis, intraoperative neuromonitoring, total intravenous anesthesia, ketamine
How to cite this article:Hendriana DR, Santosa D..; Balancing Depth and Signal: The Role of Ketamine in Anesthesia Management for Scoliosis Correction with Intraoperative Neuromonitoring..Int J Drug Deliv Technol. 2026;16(1s): 688-692; DOI: 10.25258/ijddt.16. 688-692