Basics of Neuromonitoring and Anesthetic Considerations

Shilpa Rao; James Kurfess; Miriam M. Treggiari

doi:10.1016/j.anclin.2020.11.009

Basics of Neuromonitoring and Anesthetic Considerations

Shilpa Rao
, James Kurfess
, Miriam M. Treggiari

Research output: Contribution to journal › Review article › peer-review

6 Scopus citations

Abstract

It is important anesthesiologists understand the pharmacologic interactions of anesthetics and monitoring of evoked potentials or electroencephalography. Intravenous and inhaled anesthetics have varying degrees of influence on different monitoring modalities and can affect amplitude and latency of evoked potentials or voltage and frequency of electroencephalography. Sudden and abrupt changes in monitoring are concerning and should be evaluated promptly. The source of the changes is related to sudden modifications of anesthesia delivery, variations in vital parameters, or the result of surgical manipulation. Identifying sources of abnormal signals and determining the reason for the change should be addressed immediately and corrected accordingly.

Original language	English (US)
Pages (from-to)	195-209
Number of pages	15
Journal	Anesthesiology Clinics
Volume	39
Issue number	1
DOIs	https://doi.org/10.1016/j.anclin.2020.11.009
State	Published - Mar 2021
Externally published	Yes

Funding

No conflicts of interest. • With the increasing use of neuromonitoring modalities during intracranial, carotid and spine procedures, it is important to understand the effects of physiological changes and pharmacologic interventions on these monitoring modalities. • There is currently a level I recommendation for the use of multimodal intraoperative neuromonitoring (including SSEPs and MEPs) during procedures involving the spine. This recommendation is based on the reliability and validity of these monitoring modalities in assessing spinal cord integrity. • MEPs are superior to SSEP recordings as diagnostic adjuncts for the assessment of spinal cord integrity. • There is insufficient evidence for routine use of neuromonitoring for routine cervical spine procedures in neurologically intact patients. • Controversies continue to exist regarding the cost effectiveness of use of intraoperative multimodal neuromonitoring for procedures other than spine surgery.

Funders
MEPs

Keywords

Burst suppression
Electroencephalography
Evoked potentials

ASJC Scopus subject areas

Anesthesiology and Pain Medicine

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10.1016/j.anclin.2020.11.009

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abstract = "It is important anesthesiologists understand the pharmacologic interactions of anesthetics and monitoring of evoked potentials or electroencephalography. Intravenous and inhaled anesthetics have varying degrees of influence on different monitoring modalities and can affect amplitude and latency of evoked potentials or voltage and frequency of electroencephalography. Sudden and abrupt changes in monitoring are concerning and should be evaluated promptly. The source of the changes is related to sudden modifications of anesthesia delivery, variations in vital parameters, or the result of surgical manipulation. Identifying sources of abnormal signals and determining the reason for the change should be addressed immediately and corrected accordingly.",

keywords = "Burst suppression, Electroencephalography, Evoked potentials",

author = "Shilpa Rao and James Kurfess and Treggiari, \{Miriam M.\}",

note = "Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

year = "2021",

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doi = "10.1016/j.anclin.2020.11.009",

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AU - Kurfess, James

AU - Treggiari, Miriam M.

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N2 - It is important anesthesiologists understand the pharmacologic interactions of anesthetics and monitoring of evoked potentials or electroencephalography. Intravenous and inhaled anesthetics have varying degrees of influence on different monitoring modalities and can affect amplitude and latency of evoked potentials or voltage and frequency of electroencephalography. Sudden and abrupt changes in monitoring are concerning and should be evaluated promptly. The source of the changes is related to sudden modifications of anesthesia delivery, variations in vital parameters, or the result of surgical manipulation. Identifying sources of abnormal signals and determining the reason for the change should be addressed immediately and corrected accordingly.

AB - It is important anesthesiologists understand the pharmacologic interactions of anesthetics and monitoring of evoked potentials or electroencephalography. Intravenous and inhaled anesthetics have varying degrees of influence on different monitoring modalities and can affect amplitude and latency of evoked potentials or voltage and frequency of electroencephalography. Sudden and abrupt changes in monitoring are concerning and should be evaluated promptly. The source of the changes is related to sudden modifications of anesthesia delivery, variations in vital parameters, or the result of surgical manipulation. Identifying sources of abnormal signals and determining the reason for the change should be addressed immediately and corrected accordingly.

KW - Burst suppression

KW - Electroencephalography

KW - Evoked potentials

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UR - https://www.scopus.com/pages/publications/85100587541#tab=citedBy

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DO - 10.1016/j.anclin.2020.11.009

M3 - Review article

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JO - Anesthesiology Clinics

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IS - 1

ER -

Basics of Neuromonitoring and Anesthetic Considerations

Abstract

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Keywords

ASJC Scopus subject areas

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