Intraoperative neurophysiological monitoring for the anaesthetist

Walt, Johan J N Van Der; Thomas, Jennifer; Figaji, Anthony

doi:10.1080/22201173.2013.10872913

Cited by 3 publications

(8 citation statements)

References 7 publications

(38 reference statements)

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“…Both cause an increase in the amplitude of cortical MEP and SSEP. When used along with TIVA, both enhance the evoked responses that are otherwise difficult to elicit under general anaesthesia 52 . Ketamine‐based anaesthetic regimen was successful in eliciting MEP responses when reliable MEP were not recorded with propofol in children of <6 years of age undergoing spine surgeries 4 .…”

Section: Methodsmentioning

confidence: 99%

“…But, some practitioners use low doses of muscle relaxants to prevent patient movement during IONM. 52 Whenever neuromuscular blockers (NMBs) are used during IONM, the adequacy of neuromuscular blockade should be monitored by the train of four (TOF) count.…”

Section: Neuromuscular Blockersmentioning

confidence: 99%

“…Even at higher doses, they preserve MEP and SSEP responses. 52 So opioids have become popular during IONM along with TIVA. Opioids provide excellent analgesia and help to reduce the dose of TIVA propofol and give good intraoperative hemodynamic stability.…”

Section: Opioidsmentioning

confidence: 99%

“…52 Ketamine-based anaesthetic regimen was successful in eliciting MEP responses when reliable MEP were not recorded with propofol in children of <6 years of age undergoing spine surgeries 4. It should be noted that ketamine and etomidate should not be used to increase the amplitude of evoked responses if there is a TA B L E 2…”

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confidence: 99%

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Intraoperative neurophysiological monitoring in paediatric neurosurgery

2021

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Intraoperative neurophysiological monitoring (IONM) in paediatric neurosurgeries is emerging over the past few years, and it is being widely used to decrease the risk of postoperative deficits. The same techniques of IONM used in adults can be used in paediatric patients with some modifications keeping in consideration their immature developing nervous system. Neurophysiology in children differs from that in adults. In paediatric patients, the IONM signals and responses differ according to the age of the child. The type of surgery and the neuronal pathways expected to be at risk, determine the type of IONM modality used. 1,2 Various factors like age, type and location of the lesion, preoperative neurological functional status should be considered while using IONM in paediatric patients. There are also immense challenges with anaesthesia maintenance in children undergoing IONM. Also, the IONM signals and responses are not as easily obtained as in adults due to many factors related to the immature nervous system. 3,4

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Section: Methodsmentioning

confidence: 99%

Section: Neuromuscular Blockersmentioning

confidence: 99%

Section: Opioidsmentioning

confidence: 99%

mentioning

confidence: 99%

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Intraoperative neurophysiological monitoring in paediatric neurosurgery

2021

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“…Considering those date, intraoperative neurophysiological monitoring (IOM) represents a suitable modality for the assessment of the integrity of the nervous system with a real time feedback [32,45,52].…”

Section: Introductionmentioning

confidence: 99%

Physiological alteration and anaesthetic drugs effects on intraoperative neurophysiological monitoring procedures

Coșman¹,

Atomei²,

Straticiuc³

et al. 2020

roneuro

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Intraoperative neurophysiological monitoring (IOM) and especially motor evoked potentials represents an important tool in the evaluation of the nervous system integrity and particularly of the motor tracts. A real and correct registration of the potentials with a proper interpretation of the modification is mandatory for an optimal outcome in eloquent areas, tumours, brainstem and medullary lesions. For all this to happen a suitable anaesthetic protocol must be used. Even though there is a large spectrum of anaesthetic agents at our disposal it is imperative to know their effect on the IOM signals recordings and the fact that some of them are dose-dependent. Drugs effects and physiological changes produced intraoperatively must be corrected before a shift in the direction of the surgical lesion resection it is taken. We present an overview of the action of the anaesthetic agents, most used protocols and the physiological alteration encountered in the operative theatre.

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Prognosis of Significant Intraoperative Neurophysiologic Monitoring Events in Severe Spinal Deformity Surgery

Bjerke

Zuchelli²,

Nemani

et al. 2017

Spine Deformity

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Intraoperative signal changes were most frequently from traction or positioning. However, the most common cause of persistent neurologic deterioration and the only cause of postoperative neurologic deficit was the performance of osteotomies. Unlike traction- or instrument-related correction, osteotomies produce irreversible changes, from canal intrusion or sudden localized deformity change. The incidence of postoperative neurologic deficit is very low when the inciting cause is reversed; however, osteotomy-related events are irreversible, with a high incidence of associated lasting neurologic injury.

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Intraoperative neurophysiological monitoring for the anaesthetist

Cited by 3 publications

References 7 publications

Intraoperative neurophysiological monitoring in paediatric neurosurgery

Intraoperative neurophysiological monitoring in paediatric neurosurgery

Physiological alteration and anaesthetic drugs effects on intraoperative neurophysiological monitoring procedures

Prognosis of Significant Intraoperative Neurophysiologic Monitoring Events in Severe Spinal Deformity Surgery

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