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Intraoperative monitoring

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https://www.readbyqxmd.com/read/28922579/evaluating-real-time-effects-of-topical-1-1000-epinephrine-in-endoscopic-sinus-and-skull-base-surgery-on-hemodynamic-parameters-through-intraoperative-arterial-line-monitoring
#1
Michael T Yim, Omar G Ahmed, Masayoshi Takashima
BACKGROUND: Administration of topical 1:1000 epinephrine is commonly used in practice to achieve vasoconstriction during endoscopic sinus surgery and skull-base surgery; however, real-time effects on cardiovascular changes from systemic absorption have not been well studied. METHODS: Twenty-six patients undergoing endoscopic transsphenoidal resection of a pituitary lesion at a single institution were included into the study. Following arterial line placement by anesthesiology, 6 cottonoid pledgets soaked in 1:1000 epinephrine were placed into the bilateral nasal passages...
September 18, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28922340/the-impact-of-continuous-non-invasive-arterial-blood-pressure-monitoring-on-blood-pressure-stability-during-general-anaesthesia-in-orthopaedic-patients-a-randomised-trial
#2
Agnes S Meidert, Johanna S Nold, Roman Hornung, Alexander C Paulus, Bernhard Zwißler, Stephan Czerner
BACKGROUND: In patients undergoing general anaesthesia, intraoperative hypotension occurs frequently and is associated with adverse outcomes such as postoperative acute kidney failure, myocardial infarction or stroke. A history of chronic hypertension renders patients more susceptible to a decrease in blood pressure (BP) after induction of general anaesthesia. As a patient's BP is generally monitored intermittently via an upper arm cuff, there may be a delay in the detection of hypotension by the anaesthetist...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#3
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28921173/maximizing-safe-resections-the-roles-of-5-aminolevulinic-acid-and-intraoperative-mr-imaging-in-glioma-surgery-review-of-the-literature
#4
REVIEW
Eric Suero Molina, S Schipmann, W Stummer
Malignant glioma surgery involves the challenge of preserving the neurological status of patients harboring these lesions while pursuing a maximal tumor resection, which is correlated with overall and progression-free survival. Presently, several tools exist for assisting neurosurgeons in visualizing malignant tissue. Fluorescence-guided surgery (FGS) with 5-aminolevulinic acid (5-ALA) has increasingly been used during the last decade for identifying malignant glioma. Intraoperative magnetic resonance imaging (iMRI), first introduced in the mid-1990s, is being evaluated as a further tool to maximize the extent of resection...
September 18, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28917280/a-novel-use-of-the-intraoperative-mri-for-metastatic-spine-tumors-laser-interstitial-thermal-therapy-for-percutaneous-treatment-of-epidural-metastatic-spine-disease
#5
REVIEW
Jonathan G Thomas, Wajd N Al-Holou, Dhiego Chaves de Almeida Bastos, Amol J Ghia, Jing Li, Andrew J Bishop, Behrang Amini, Laurence D Rhines, Claudio E Tatsui
Spinal laser interstitial thermal therapy (LITT) appears to be a promising novel modality for treatment of epidural metastatic spine disease in patients who are poor candidates for larger-scale oncologic spinal surgery and can act synergetically with spinal stereotactic radiosurgery to maximize local control and palliate pain. This technique is ideally suited for the intraoperative MRI suite to monitor the extent of the ablation in the epidural space. As percutaneous navigation, imaging, and LITT technology improve, broader applicability of this minimally invasive technique in spinal oncology is foreseen...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28899835/successful-treatment-by-microvascular-decompression-surgery-of-a-patient-with-hemiparesis-due-to-vertebral-artery-compression-of-the-medulla-oblongata-a-case-report-and-literature-review
#6
Jibin Ren, Hongtao Sun, Yunfeng Diao, Xuegang Niu, Hang Wang, Zhengjun Wei, Fei Yuan
Little literature is available on hemiparesis caused by vascular medullary compression, which may occur as a result of dolichoectasia of the vertebrobasilar arterial system. In this paper, we report a case of vertebral artery compression of the medulla oblongata in a 67-year old woman. The patient was hypertensive and developed hemiparesis and intermittent spasms for five years, which became worsened for one year. Cranial nerve MRI showed compression of the medulla oblongata by the left vertebral artery. Motor evoked potential (MEP) examination showed abnormal conduction of MEPs of bilateral toe abductors...
September 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28898453/echocardiographic-guidance-and-monitoring-of-left-atrial-appendage-closure-with-atriclip-during-open-chest-cardiac-surgery
#7
Rachele Contri, Sara Clivio, Tiziano Torre, Tiziano Cassina
Left atrial appendage (LAA) closure prevents thromboembolic risk and avoids lifelong anticoagulation due to atrial fibrillation (AF). Nowadays, AtriClip, a modern epicardial device approved in June 2010, allows external and safe closure of LAA in patients undergoing cardiac surgery during other open-chest cardiac surgical procedures. Such a surgical approach and its epicardial deployment differentiates LAA closure with AtriClip from percutaneous closure techniques such as Watchman (Boston Scientific, Marlborough, MA, USA), Lariat (SentreHEART Inc...
September 12, 2017: Echocardiography
https://www.readbyqxmd.com/read/28898173/utility-of-stereoelectroencephalography-in-children-with-dysembryoplastic-neuroepithelial-tumor-and-cortical-malformation
#8
Jun T Park, Guadalupe Fernandez Baca Vaca, Jennifer Avery, Jonathan P Miller
BACKGROUND: Uncontrolled seizures in children can contribute to irreversible cognitive impairment and developmental delay, in addition to placing them at risk for sudden unexplained death in epileptic patients (SUDEP). Since its introduction at Saint Ann Hospital in Paris in the 1960s, stereoelectroencephalography (SEEG) is increasingly being utilized at epilepsy centers in the United States as an invasive tool to help localize the seizure focus in drug-resistant focal epilepsy. INDICATIONS: Children with symptomatic epilepsy, commonly due to cortical dysplasia and dysembryoplastic neuroepithelial tumor (DNET), may benefit from SEEG investigation...
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/28895459/hearing-loss-following-posterior-fossa-microvascular-decompression-a-systematic-review
#9
Matthew Bartindale, Matthew Kircher, William Adams, Neelam Balasubramanian, Jeffrey Liles, Jason Bell, John Leonetti
Objectives (1) Determine the prevalence of hearing loss following microvascular decompression (MVD) for trigeminal neuralgia (TN) and hemifacial spasm (HFS). (2) Demonstrate factors that affect postoperative hearing outcomes after MVD. Data Sources PubMed-NCBI, Scopus, CINAHL, and PsycINFO databases from 1981 to 2016. Review Methods Systematic review of prospective cohort studies and retrospective reviews in which any type of hearing loss was recorded after MVD for TN or HFS. Three researchers extracted data regarding operative indications, procedures performed, and diagnostic tests employed...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28887783/a-novel-integration-of-spectral-domain-optical-coherence-tomography-and-laser-ablation-system-for-precision-treatment
#10
Yingwei Fan, Boyu Zhang, Wei Chang, Xinran Zhang, Hongen Liao
PURPOSE: Complete resection of diseased lesions reduces the recurrence of cancer, making it critical for surgical treatment. However, precisely resecting residual tumors is a challenge during operation. A novel integrated spectral-domain optical-coherence-tomography (SD-OCT) and laser-ablation therapy system for soft-biological-tissue resection is proposed. This is a prototype optical integrated diagnosis and therapeutic system as well as an optical theranostics system. METHODS: We develop an optical theranostics system, which integrates SD-OCT, a laser-ablation unit, and an automatic scanning platform...
September 9, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28882717/the-effects-of-combined-intraoperative-monitoring-of-abnormal-muscle-response-and-z-l-response-for-hemifacial-spasm
#11
Xin Zhang, Hua Zhao, Yin-Da Tang, Jin Zhu, Ping Zhou, Yan Yuan, Shi-Ting Li
BACKGROUND: Microvascular decompression (MVD) is the most useful treatment for hemifacial spasm (HFS). During MVD surgery, abnormal muscle response (AMR) is widely used. ZL response (ZLR) is a new monitoring method for HFS. We compared the effect of AMR plus ZLR and simple AMR. METHODS: We performed a retrospective study of 1,868 cases of HFS treated using intraoperative monitoring between January 2013 and December 2015. Among the 1,868 cases, 896 patients underwent simple AMR monitoring and 972 underwent combined intraoperative monitoring of AMR and ZLR...
September 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28882599/a-network-level-approach-of-cognitive-flexibility-impairment-after-surgery-of-a-right-temporo-parietal-glioma
#12
E Mandonnet, L Cerliani, K Siuda-Krzywicka, I Poisson, N Zhi, E Volle, M T de Schotten
OBJECTIVE: The right "non-dominant" temporo-parietal junction is usually not considered as a highly eloquent area. This contrasts with its mirrored left "dominant" counterpart, which is known as highly eloquent regarding language function. The question arises about which functions should be monitored when operating lesions of the right temporo-parietal junction under awake conditions. METHODS: We report the case of a patient who underwent a surgical resection of a glioma located in the right temporo-parietal junction...
September 4, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28882353/neurophysiological-monitoring-in-radiofrequency-ablation-of-spinal-osteoid-osteoma-with-a-progressive-time-and-temperature-protocol-in-children
#13
Mariano A Nöel, Martin J Segura, Sergio Sierre, Ida A Francheri Wilson, Carlos A Tello, Eduardo Galaretto, Rodrigo G Remondino, María E Talarico, Ernesto S Bersusky, Lucas Piantoni
STUDY DESIGN: Retrospective. Level IV Evidence. OBJECTIVE: To assess the utility of intraoperative neurophysiological monitoring (IONM) to detect and eventually prevent impending neurovascular damage during computed tomography (CT)-guided radiofrequency ablation (RFA) of spinal osteoid osteoma (OO) in children. SUMMARY AND BACKGROUND DATA: To our knowledge, this is the first case series of spinal OO in pediatric patients treated at a single center employing IONM during RFA...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28877048/current-opinion-in-otolaryngology-update-on-vascular-injuries-in-craniomaxillofacial-fractures
#14
Elisa Illing, Sarah Jo Burgin, Cecelia E Schmalbach
PURPOSE OF REVIEW: The primary purpose of this chapter is to define current recommendations for vascular work-up of patients with craniomaxillofacial (CMF) trauma with emphasis on imaging to include intraoperative fluorescence, angiography, and surgical exploration. The second goal is to review current management recommendations for observation versus surgical exploration based on the neck zones of injury. RECENT FINDINGS: Over the past two decades, endovascular techniques are increasingly utilized, particularly in zones I and III of the neck...
September 4, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28875137/risk-factor-analysis-of-additional-administration-of-sedative-agent-and-patient-dissatisfaction-in-intravenous-conscious-sedation-using-midazolam-for-third-molar-extraction
#15
Dong-Whan Shin, Jin-Yong Cho, Yoon-Sic Han, Hye-Young Sim, Hee-Sun Kim, Da-Un Jung, Ho Lee
OBJECTIVES: The primary purpose of this study was to investigate the factors related with additional administration of sedative agent during intravenous conscious sedation (IVS) using midazolam (MDZ). The secondary purpose was to analyze the factors affecting patient satisfaction. MATERIALS AND METHODS: Clinical data for 124 patients who had undergone surgical extraction of mandibular third molar under IVS using MDZ were retrospectively investigated in this case-control study...
August 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28870837/post-tetanic-transcranial-motor-evoked-potentials-augments-the-amplitude-of-compound-muscle-action-potentials-recorded-from-innervated-and-non-innervated-muscles
#16
Hideki Shigematsu, Masahiko Kawaguchi, Hironobu Hayashi, Tsunenori Takatani, Eiichiro Iwata, Masato Tanaka, Akinori Okuda, Yasuhiko Morimoto, Keisuke Masuda, Yuusuke Yamamoto, Yasuhito Tanaka
BACKGROUND CONTEXT: Transcranial electrical stimulation used to produce motor evoked potentials (TES-MEP) and subsequent compound muscle action potential (CMAP) recording is widely used to monitor motor function during surgery when there is risk of damaging the spinal cord. Nonetheless, some muscles do not produce CMAP amplitudes sufficient for intraoperative monitoring. PURPOSE: To investigate the utility of tetanic stimulation at single and multiple peripheral nerve sites for augmenting CMAP amplitudes recorded from innervated and non-innervated muscles...
September 1, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28868196/novel-approach-to-continuous-neurophysiological-monitoring-during-surgery-of-peripheral-nerve-tumors
#17
Ángel Saponaro-González, Pedro Javier Pérez-Lorensu
BACKGROUND: Intraoperative neurophysiological monitoring (IONM) with nerve action potential (NAP) can be useful during peripheral nerve surgery. However, current methodologies are not optimized for continuous recording of the NAP. The use of newer electrodes may make it possible to more conveniently obtain continuous recordings of the NAP during surgery. METHODS: After localizing the nerve of interest and dissecting it from the adjacent soft tissue, two APS(®) (Automatic Periodic Stimulation) electrodes, originally designed for stimulation of the vagus nerve during thyroid surgery, are placed on the nerve on either sides of the tumor for stimulation and recording using two subdermal electroencephalogram (EEG) needles as anode and reference, respectively...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28866320/differences-in-perioperative-femoral-and-radial-arterial-blood-pressure-in-neonates-and-infants-undergoing-pediatric-cardiac-surgery-requiring-cardiopulmonary-bypass
#18
Hwa Jin Cho, Sang Hoon Lee, In Seok Jeong, Nam Sik Yoon, Jae Sook Ma, Byoung Hee Ahn
OBJECTIVE: Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. METHOD: The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed...
August 30, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28863007/intraoperative-neurophysiologic-monitoring-for-prediction-of-postoperative-neurological-improvement-in-a-child-with-chiari-type-i-malformation
#19
Yukari Kawasaki, Susumu Uchida, Kouhei Onishi, Masako Toyokuni, Kazuo Okanari, Minoru Fujiki
INTRODUCTION: Although many surgical treatment strategies for Chiari malformation type I (CM-I) have been reported, the most appropriate surgical technique remains controversial. It is wholly ascribable to the complicacy of pathological condition in CM-I. Recently, intraoperative neurophysiologic monitoring (INM) is becoming prevalent in spinal surgery. Indeed, motor-evoked potentials (MEPs) monitoring and somatosensory-evoked potentials (SSEPs) monitoring are standard tools to minimize the risk of neurologic injury and postoperative deficits...
August 31, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28862518/optimal-stimulation-parameters-for-intraoperative-bulbocavernosus-reflex-in-infants
#20
Hyeoncheol Hwang, Kyu-Chang Wang, Moon Suk Bang, Hyung-Ik Shin, Seung-Ki Kim, Ji Hoon Phi, Ji Yeoun Lee, Jinwoo Choi, Seungwoo Cha, Keewon Kim
OBJECTIVE The aim of this study was to establish optimal electric stimulation parameters for intraoperatively monitoring the bulbocavernosus reflexes (BCRs) in infants. METHODS The authors retrospectively reviewed the medical records of all infants (age < 24 months) who had undergone an untethering operation for tethered cord syndrome between May 2013 and February 2014 at a single institution and whose baseline BCR had been elicited during surgery. Using different combinations of stimulation parameters-number of stimulation pulses: 4 or 8 pulses, interpulse interval: 1, 2, or 5 msec, and polarity of stimulation: biphasic or monophasic-the authors compared the relative mean amplitude of 10 BCR responses (rmaBCRs) to each combination of parameters...
September 1, 2017: Journal of Neurosurgery. Pediatrics
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