[Anesthetic and physiologic implications of neurophysiologic monitoring with evoked potentials during spinal surgery].
Neurophysiologic monitoring with somatosensory and motor evoked potentials in spinal surgery is now widely applied in order to reduce the risk of neural injury and facilitate intraoperative decision making. Most anesthetics affect such monitoring by altering both somatosensory and motor evoked responses and these effects may place constraints on the choice of anesthetic. Intraoperative management includes maintaining stable physiologic conditions, which involves adjusting hemodynamic parameters, maintaining normal blood flow to promote proper oxygen exchange, ensuring proper ventilation, and avoiding variations in temperature. Close collaboration between the anesthetist, the surgeon, and the neurophysiologist will ensure the success of intraoperative monitoring and make it possible to avoid neural injury by making timely changes in the surgical approach.
Valverde Junguito
J L
JL
Departamento Anestesiología Reanimación, Hospital Universitario de Canarias, Tenerife. jvalverj@telefonica.net
Aldana Díaz
E M
EM
Pérez Lorensu
P J
PJ
González Miranda
F
F
D018681:Anesthetics, General / Q000494:pharmacology*; D018685:Anesthetics, Inhalation / Q000494:pharmacology; D018686:Anesthetics, Intravenous / Q000494:pharmacology; D016477:Artifacts; D001831:Body Temperature; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology; D005188:False Negative Reactions; D018056:Hemorheology; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D000860:Hypoxia / Q000503:physiopathology; D007427:Intracranial Pressure; D007431:Intraoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D016343:Monitoring, Intraoperative / Q000379:methods*; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology; D019635:Neurosurgical Procedures; D019637:Orthopedic Procedures; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D011930:Reaction Time / Q000187:drug effects; D012121:Respiration, Artificial; D013131:Spine / Q000601:surgery*
D018681:Anesthetics, General; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D009466:Neuromuscular Blocking Agents