Intraoperative Neuromonitoring in Pediatric and Adult Spine Deformity Surgery

Strike, Sophia A.; Hassanzadeh, Hamid; Jain, Amit; Kebaish, Khaled M.; Njoku, Dolores B.; Becker, Daniel; Ain, Michael C.; Sponseller, Paul D.

doi:10.1097/bsd.0000000000000388

Cited by 29 publications

(38 citation statements)

References 25 publications

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“…IV anesthetics are often used to minimize use of inhalational anesthetics. 51 The wake-up test is the gold standard and still has a role intraoperatively. The wakeup test assesses gross motor function and may be used to confirm persistent SSEP and MEP changes.…”

Section: Neuromonitoringmentioning

confidence: 99%

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Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

2020

Pediatric Clinics of North America

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Section: Neuromonitoringmentioning

confidence: 99%

“…The wakeup test assesses gross motor function and may be used to confirm persistent SSEP and MEP changes. 51 The depth of anesthesia is reduced to allow patients to follow commands to move upper and lower extremities. Risks of extubation, intraoperative recall, and air embolism exist.…”

Section: Neuromonitoringmentioning

confidence: 99%

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

2020

Pediatric Clinics of North America

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“…After being notified of the presence of warning criteria, the surgeon often will take immediate action. Possible corrective measures include ordering an increase in the patient's mean arterial blood pressure, releasing spinal column adjustments, ensuring the anesthetic regimen has not changed, administering steroids, and ordering a Stagnara wake‐up test …”

Section: Neuromonitoring In the Ormentioning

confidence: 99%

“…The Stagnara wake‐up test is a definitive motor evaluation: the patient either can or cannot move. However, a reduction in the strength of the performed movements can be a sign of postoperative deficit …”

Section: Neuromonitoring In the Ormentioning

confidence: 99%

“…Possible corrective measures include ordering an increase in the patient's mean arterial blood pressure, releasing spinal column adjustments, ensuring the anesthetic regimen has not changed, administering steroids, and ordering a Stagnara wake-up test. 30 Before the start of the procedure, the OR team should designate an individual to perform a Stagnara wake-up test if one is needed intraoperatively. This individual does not need to be an IONM staff member or the surgeon; however, he or she does need to conduct a preoperative neurological assessment.…”

Section: Transcranial Electrical Motor Evoked Potentialsmentioning

confidence: 99%

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Intraoperative Neuromonitoring: Principles and Considerations for Perioperative Nurses

Roth¹,

Rakers²

2019

AORN Journal

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Intraoperative neuromonitoring (IONM) is a method used to warn the surgeon of impending neurological damage while it can still be corrected, ideally preventing a permanent neurological deficit in the surgical patient. It was originally used in neurosurgery, but now also applies to other surgical specialties. Comprehensive monitoring of a patient's neurological status requires using a variety of approaches. The IONM tests most frequently used in the OR are somatosensory evoked potentials; transcranial electrical motor evoked potentials; electromyography, including cranial nerve monitoring; and electroencephalography. With its increased use during a variety of operative and other invasive procedures, most perioperative nurses will be exposed to IONM at some point in their careers. This article provides perioperative nurses with a basic understanding of IONM, including the framework, purpose, associated terminology, and nursing implications.

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Pediatric Neuroanesthesia — a Review of the Recent Literature

Szántó

Gál

Tankó

et al. 2022

Curr Anesthesiol Rep

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Purpose of Review Pediatric neuroanesthesia is a growing and still challenging subspecialty. The purpose of this review is to summarize the available knowledge and highlight the most recent findings of the literature on non-traumatic pediatric neuroanesthesia care. Recent Findings Several human studies have confirmed the negative effects of early life anesthetic exposure. According to non-human studies, volatile anesthetics and opioids contribute to tumor progression. Tranexamic acid effectively reduces perioperative blood loss; it is used in several different doses without standard guidelines on optimal dosing. The widespread use of neuromonitoring has necessitated the development of anesthetic methods that do not affect neuromuscular transmission. Summary Pediatric anesthetic neurotoxicity, management of intraoperative bleeding, and the effect of anesthesia on tumor growth are among the most debated and researched topics in pediatric neuroanesthesia. The lack of evidence and clinical guidelines underlines the need for further large prospective studies in this subspecialty.

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Intraoperative Neuromonitoring in Pediatric and Adult Spine Deformity Surgery

Abstract: Familiarity with the history of neuromonitoring in spinal deformity surgery and an understanding of the physiological systems used for neuromonitoring provide a framework from which spine surgeons can select appropriate monitoring for their patients.

Cited by 29 publications

References 25 publications

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

Pediatric Anesthesia Concerns and Management for Orthopedic Procedures

Intraoperative Neuromonitoring: Principles and Considerations for Perioperative Nurses

Pediatric Neuroanesthesia — a Review of the Recent Literature

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