Intraoperatives elektrophysiologisches Monitoring mit evozierten Potenzialen

TY - JOUR

T1 - Intraoperatives elektrophysiologisches Monitoring mit evozierten Potenzialen

AU - Nitzschke, R

AU - Hansen-Algenstaedt, N

AU - Regelsberger, J

AU - Goetz, A E

AU - Goepfert, M S

PY - 2012/4

Y1 - 2012/4

N2 - During the last 30 years intraoperative electrophysiological monitoring (IOEM) has gained increasing importance in monitoring the function of neuronal structures and the intraoperative detection of impending new neurological deficits. The use of IOEM could reduce the incidence of postoperative neurological deficits after various surgical procedures. Motor evoked potentials (MEP) seem to be superior to other methods for many indications regarding monitoring of the central nervous system. During the application of IOEM general anesthesia should be provided by total intravenous anesthesia with propofol with an emphasis on a continuous high opioid dosage. When intraoperative MEP or electromyography guidance is planned, muscle relaxation must be either completely omitted or maintained in a titrated dose range in a steady state. The IOEM can be performed by surgeons, neurologists and neurophysiologists or increasingly more by anesthesiologists. However, to guarantee a safe application and interpretation, sufficient knowledge of the effects of the surgical procedure and pharmacological and physiological influences on the neurophysiological findings are indispensable.

AB - During the last 30 years intraoperative electrophysiological monitoring (IOEM) has gained increasing importance in monitoring the function of neuronal structures and the intraoperative detection of impending new neurological deficits. The use of IOEM could reduce the incidence of postoperative neurological deficits after various surgical procedures. Motor evoked potentials (MEP) seem to be superior to other methods for many indications regarding monitoring of the central nervous system. During the application of IOEM general anesthesia should be provided by total intravenous anesthesia with propofol with an emphasis on a continuous high opioid dosage. When intraoperative MEP or electromyography guidance is planned, muscle relaxation must be either completely omitted or maintained in a titrated dose range in a steady state. The IOEM can be performed by surgeons, neurologists and neurophysiologists or increasingly more by anesthesiologists. However, to guarantee a safe application and interpretation, sufficient knowledge of the effects of the surgical procedure and pharmacological and physiological influences on the neurophysiological findings are indispensable.

KW - Electric Stimulation

KW - Electroencephalography

KW - Electromyography

KW - Evoked Potentials/physiology

KW - Evoked Potentials, Motor/physiology

KW - Evoked Potentials, Somatosensory/physiology

KW - Humans

KW - Intraoperative Complications/physiopathology

KW - Monitoring, Intraoperative/methods

KW - Neurosurgery

KW - Spinal Cord/physiology

KW - Thoracic Surgery

KW - Vascular Surgical Procedures

U2 - 10.1007/s00101-012-2015-3

DO - 10.1007/s00101-012-2015-3

M3 - SCORING: Review

C2 - 22526743

VL - 61

SP - 320

EP - 335

JO - ANAESTHESIST

JF - ANAESTHESIST

SN - 0003-2417

IS - 4

ER -