Principles of intraoperative neurophysiological monitoring and anaesthetic considerations. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Sanders, Brett; Catania, Santiago; Luoma, Astri MV.
• Is Part Of: Anaesthesia and intensive care medicine. Volume 21:Issue 1(2020)
• Page Start: 39
• Page End: 44
• Publication Date: 2020-01
• Subjects: Compound muscle action potential (CMAP) -- corticospinal tract -- dorsal columns -- electroencephalography (EEG) -- electromyography (EMG) -- evoked potentials (EPs) -- intraoperative neurophysiological monitoring (IONM) -- motor evoked potentials (MEPs) -- somatosensory evoked potentials (SEPs); Anesthesiology -- Periodicals; Critical care medicine -- Periodicals; Anesthesia -- Periodicals; Intensive care -- Periodicals; Electronic journals; Periodicals; 617.9605
• DOI: 10.1016/j.mpaic.2019.10.020
• Languages: English
• ISSNs: 1472-0299

Abstract

Abstract: Surgery to the nervous system poses risks to neural structures be that mechanical, haemodynamical, chemical or thermal. The role of intraoperative neurophysiological monitoring (IONM) is to facilitate the assessment of the functional integrity of neural structures and provide a real time alerting system when changes caused by surgically induced insults are detected, with the goal of reducing the risk of postoperative neurological deficits. Furthermore, it is also used as a guidance system to map eloquent areas within the cortex and to identify specific neuronal structures, particularly when landmarks cannot be easily recognized. In this article, we focus on the various neurophysiological modalities used in intraoperative monitoring, their basic principles, indications and the information that they provide. We also examine the anaesthetic considerations and the checklist for the multidisciplinary team should an intraoperative alert be issued.