BookChristoph N. Seubert, Jeffrey R. Balzer, editors.
Summary: As a single-source volume on intraoperative neurophysiological monitoring (IOM), previous editions of this celebrated resource amounted to a mission statement from the pioneer generation in intraoperative neurophysiology, converting insights, techniques, and perspectives into tools providing clinical utility for the assessment of the nervous system in patients who could not be assessed by a standard neurological examination. Now directed by a new generation of experts, this thoroughly illustrated Third Edition is updated with new case material, images, videos, practice guidelines, references, and technologies, and is intended for those who encounter IOM in the operating room and intensive care unit, including anesthesiologists, technologists, neurophysiologists, surgeons, and nurses, as well as graduate students and trainees. Offering topical, applicable information, this accessible reference and teaching tool provides practical knowledge to help students, trainees, and team members better understand one anothers roles, thereby improving patient safety and care.
Contents:
Intro
Preface
Acknowledgments
Contents
Contributors
Part I: Monitoring Techniques
1: Somatosensory-Evoked Potentials
Introduction
Anatomy and Vascular Supply
Methods
Stimulation
Recording
Intraoperative Variables Affecting SSEPS: Pharmacology and Physiology
Inhalational Anesthetics
Intravenous Anesthetics
Temperature
Tissue Perfusion
Oxygenation/Ventilation
Intracranial Pressure
Other Physiologic Variables
Criteria for Intervention During Intraoperative SSEP Monitoring
Dorsal Column Mapping Other Intraoperative Applications for SSEPs
References
2: Transcranial Motor-Evoked Potentials
Introduction
Anatomy of the MEP Response
Technical Aspects of MEP Monitoring
Optimizing Compound Muscle Action Potential
Patient Characteristics Contributing to Outcomes
Effect of Anesthesia Management
Outcomes
Conclusion
References
3: Auditory-Evoked Potentials
Anatomy of the Auditory System
Conduction of Auditory Signals from Ear to Cochlea
Neural Components of the Auditory System and Electrical Generators Along the Auditory Pathway References
4: Visual-Evoked Potentials
Introduction
Flash Electroretinogram (F-ERG)
Flash Visual-Evoked Potentials (F-VEPs)
Introduction of the Intraoperative Monitoring of the Visual System: Orbital Surgeries
Identified Sources of Intraoperative Variations in F-VEPs
Recognition of a Reliable Monitoring of Vision
Anatomy and Physiology of the Visual System
Realization of Intraoperative Electroretinogram (ERG) and Flash Visual-Evoked Potentials (F-VEPs)
Intraoperative ERG
Intraoperative F-VEP
Devices for Flash Stimulation
Characteristics of Stimulation Light Cochlea: Electrocochleogram
Auditory Pathway from Cochlear Nerve to Midbrain
Auditory Brainstem-Evoked Responses and Cochlear Nerve Compound Action Potential
Primary Auditory Cortex: Mid-Latency Auditory-Evoked Potentials
Vascular Supply of Auditory Pathway Structures
Techniques for Recording Auditory-Evoked Potentials
Stimulation
Electrocochleogram
Compound Nerve Action Potentials from the Cochlear Nerve
Brainstem Auditory-Evoked Potentials
MLAEPs
Anesthetic and Physiologic Considerations for Monitoring of Auditory Brainstem Responses
ABR Alarm Criteria ERG Recordings and Analyses
F-VEP Recordings and Analyses
Warning Criteria
Warning Criteria for ERGs
Warning Criteria for F-VEPs
Other Intraoperative Applications with ERG and F-VEP: Cardiovascular Surgeries, Deep Brain Stimulation
Direct Electrical Stimulation of Visual Pathway
Effects of Temperature
Effects of Anesthesia on ERGs
Effects of Anesthesia on F-VEPs
Conclusion
References
5: Deep Brain Stimulation
Introduction
Surgery
Microelectrode Recording (MER)
Complications
Asleep vs. Awake Surgery
The MER Procedure