Impact of anesthetic management on Intraoperative Neurophysiological Monitoring: Narrative review
Keywords:Anesthesia, Neuroanesthesia, Intraoperative Neurophysiological Monitoring, Colunm surgery, Complications, Safety
The spinal pathology of the main causes of chronic neurogenic pain and disability in the general population. Intraoperative neurophysiological monitoring (IOMM) allows monitoring and evaluating the integrity of the motor and sensory systems in procedures that put the nervous system (NS) at risk and avoid complications.
Objective: Review of peer-reviewed publications; Identify and describe the main OUNM techniques and the impact of anesthetic and perioperative management on them.
Methods: A systematic and narrative search and review was carried out in English and Spanish, using the MEDLINE, Scopus and PubMed databases, using the MeSH terms: "Intraoperative Neurophysiological Monitoring"; "Anesthesia"; "Neuroanesthesia"; "Perioperative Management"; "Spine surgery", "Complications", "Safety".
Results: Current national and international clinical guidelines for spine surgery recommend multimodal MIOI in spinal and intracranial surgery to evaluate the functional integrity of the NS.
Understanding influence of anesthetics and other variables on the recordings is critical to the success of the MNIO. As the technique of choice, total intravenous anesthesia (TIVA) with propofol is recommended for a better recording of PEM and PESS (LE: 2C).
It is essential to understand the clinical bases of the different IOMM techniques and to interpret alerts and alarm criteria in a timely manner to obtain better surgical results and prevent permanent neurological injuries.
The neuroanesthesiologist must ensure an adequate state of anesthetic depth, hempodynamic stability and cerebromedullary perfusion pressure, avoiding modifications that alter the recordings.
KEY WORDS: Anesthesia; Neuroanesthesia; Intraoperative Neurophysiological Monitoring; Colunm surgery; Complications; Safety.
What do we know about this problem and what does this study contribute?
Despite the wide dissemination and recommendation of the use of Intraoperative Neurophysiological Monitoring (IONM) by international guidelines, there is little dissemination and understanding by anesthesiologists about the type of techniques, as well as the importance and impact of anesthetic and perioperative management on the same.
This study identifies and describes the main IONM techniques, as well as the impact of drugs, hemodynamic variables, anesthetic and perioperative management on IONM.
How to Cite
Copyright (c) 2022 César Alejandro Martínez de los Santos
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
© The authors. 2022. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed. Other copyright licenses may apply for articles published before 2022.