Intraoperative neurophysiologic monitoring

Gunter, Ashley; Ruskin, Keith J.

doi:10.1097/aco.0000000000000374

Cited by 20 publications

(5 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If the height of the posterior aspect of the cage is too small and the lordotic angle too large, neuroforaminal height may decrease and nerve root impingement can occur. Although intraoperative neuromonitoring is able to detect sensory or motor impairment, the somatosensory evoked potentials (SSEP) are not a reliable predictor for neuropathic pain [ 11 ]. In this study, we present a simple stepwise mathematic model to predict postsurgical neuroforaminal height depending on the configuration of the treated vertebral segment and the dimensions of the inserted hyperlordotic cage.…”

Section: Discussionmentioning

confidence: 99%

Lumbar reconstruction with hyperlordotic cages: Prediction of neuroforaminal height in comparison to established age and sex dependent reference values

Bratelj,

Jaszczuk,

Capone

et al. 2024

Heliyon

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Lumbar reconstruction with hyperlordotic cages: Prediction of neuroforaminal height in comparison to established age and sex dependent reference values

Bratelj,

Jaszczuk,

Capone

et al. 2024

Heliyon

View full text Add to dashboard Cite

“…During the anesthetic management of patients with IONM, preventing the unfavorable effects of anesthetic agents on IONM is extremely important [24]. The effects of anesthetic agents for induction have short-term effects which explains why typically IONM does not significantly affect the procedure.…”

Section: Discussionmentioning

confidence: 99%

Pediatric neuroanesthesia experiences: A single center retrospective cohort study

et al. 2023

View full text Add to dashboard Cite

Background/Aim: Pediatric neuroanesthesia is a special field that requires significant experience and infrastructure because of anatomical, neurological, and pharmacological differences in the pediatric patient population. Although technological improvements provide more effective and safer neuroanesthesiological management, the principles of neuroanesthesia, neurocognitive development, and the effects of anesthetic agents on central nervous system development are well-known. The majority of pediatric neuroanesthesia articles in the literature are reviews; however, retrospective/prospective case series and controlled research are limited. In this retrospective cohort study, we aimed to contribute to the existing literature by reviewing and analyzing our single-center 10-year experiences and results addressing pediatric neuroanesthesia management. Methods: After ethical committee approval, anesthetic and surgical reports from 1165 pediatric neurosurgical cases over ten years were collected. Demographic data, intra-operative vascular management, anesthesia techniques, airway management, patient positions, analgesia methods, and complications were evaluated in this retrospective cohort study. The available surgical intervention, patient positions, intra-operative neuromonitorization (IONM), and intra-operative magnetic resonance imaging (IOMR) records were also analyzed. Results: Six-hundred forty-six (55.4%) girls and 519 (44.5%) boys were included in the study. The median age was 60 (0–216) months. Cranial interventions were performed in 842 (72.3%) patients, and spinal interventions were performed in 323 (27.7%) patients. Patients’ American Society of Anesthesiologists (ASA) physical scales grouped as I, II, III, and IV were 718 (61.6%), 360 (30.9%), 82 (7%), and 5 (0.4%), respectively. Sevoflurane (40.3%), propofol (37.2%), and sodium thiopental (2.5%) were used for anesthetic induction. Neuromuscular block was performed with rocuronium (56.7%) and atracurium (14.4%). Neuromuscular blocking agents were not used in 337 patients (28.9%). A blood transfusion was required in 120 patients (10.3%), and 40% of these patients underwent surgery for craniosynostosis. Two-hundred twenty-two (19.1%) were monitored with IONM, and IOMR was carried out in 124 (10.6%) of the cases. The anesthesia-related complication rate was 5.15% (60 patients). Conclusion: Although pediatric neurosurgical interventions involve high risks, they are becoming increasingly common in our daily practice. Neuroanesthesiologists should know the procedures, techniques, and advances for safe and effective management of pediatric neurosurgical cases. We think that these data may be helpful as a guide for the anesthetic management of pediatric neurosurgical cases.

show abstract

“…Changes in anesthetic management lead to changes in MEPs. Comparing with inhalational anesthetics, the benefits of intravenous agents for MEP monitoring are less interference with alpha motor neuron excitability [ 22 , 23 ]. Therefore, our study applies standard anesthetic regimens by total intravenous anesthesia with propofol and remifentanil to obtain an accurate recording.…”

Section: Discussionmentioning

confidence: 99%

Effect of intraoperative muscle relaxation reversal on the success rate of motor evoked potential recording in patients undergoing spinal surgery: a randomized controlled trial

Jian,

Liu,

Liang

et al. 2023

BMC Anesthesiol

View full text Add to dashboard Cite

Background Partial neuromuscular blockade (NMB) has been applied for some surgeries to reduce bleeding and prevent patient movement for spinal surgery. Sugammadex selectively binds to rocuronium in the plasma and consequently lowers the rocuronium concentration at the neuromuscular junction. In this study, we aimed to observe whether the success rate of transcranial motor-evoked potential (TceMEP) can be increased by sugammadex compared with partial NMB during spinal surgery. Methods Patients who underwent elective spinal surgery with TceMEP monitoring were randomly assigned to the sugammadex group and control group. Rocuronium was continuously infused to maintain the train of four counts (TOFc) = 2. The sugammadex group discontinued rocuronium infusion at the time of TceMEP monitoring and was infused with 2 mg/kg sugammadex; the control group was infused with the same dose of saline. Results A total of 171 patients were included. The success rate of TceMEP monitoring in the sugammadex group was significantly higher than that in the control group. TceMEP amplitudes were greater in the sugammadex group than in the control group at 5 min, 10 min, and 20 min after the start of motor-evoked potential monitoring. The latencies of upper extremity TceMEPs monitoring showed no difference between groups. TOF ratios were greater in the sugammadex group at 5 min, 10 min, and 20 min after the start of motor-evoked potential monitoring. There were no adverse effects caused by sugammadex. Conclusions Sugammadex can improve the success rate of motor-evoked potential monitoring compared with moderate neuromuscular blockade induced by continuous infusion of rocuronium in spinal surgery. Trial registration The study was registered on clinicaltrials.gov.cn on 29/10/2020 (trial registration number: NCT04608682).

show abstract

Intraoperative neurophysiologic monitoring

Cited by 20 publications

References 17 publications

Lumbar reconstruction with hyperlordotic cages: Prediction of neuroforaminal height in comparison to established age and sex dependent reference values

Lumbar reconstruction with hyperlordotic cages: Prediction of neuroforaminal height in comparison to established age and sex dependent reference values

Pediatric neuroanesthesia experiences: A single center retrospective cohort study

Effect of intraoperative muscle relaxation reversal on the success rate of motor evoked potential recording in patients undergoing spinal surgery: a randomized controlled trial

Contact Info

Product

Resources

About