Warning criteria for intraoperative neurophysiologic monitoring
Publication in refereed journal

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其它資訊
摘要Purpose of review:
Intraoperative changes in somatosensory (SEP) and motor evoked potentials (MEPs) may indicate potential injury to the spinal cord and will require timely intervention to prevent permanent damage. This review focuses on the validity of currently recommended warning criteria for intraoperative evoked potential monitoring.
Recent findings:
Current guideline recommends a decrease in SEP amplitude by 50% and MEP amplitude by 50–100% as warning signals for injury to the ascending sensory and descending motor pathway, respectively. On the basis of cohort studies, the diagnostic accuracy of SEP and MEP to predict postoperative neurologic deficits was variable. Importantly, 0.1–4.1% of monitored patients suffered postoperative neurologic deficit despite apparently normal SEP and MEP recordings (i.e. false negative events). These data suggested that the true warning criteria may be lower than previously acknowledged. A systematic review of studies that reported changes in SEP or MEP monitoring and postoperative neurological outcome showed an association between changes in monitoring signals and postoperative neurological deficits. However, the confidence intervals were wide and it is not possible to determine a threshold value in SEP or MEP amplitude beyond which may indicate neurologic deficit.
Summary:
Current recommendations for warning criteria during intraoperative evoked potential monitoring are empirically derived. Until a threshold that predicts spinal cord injury can be accurately determined, it remains difficult to define the clinical utility of intraoperative neurophysiologic monitoring.
出版社接受日期15.07.2017
著者Liu Quanmeng, Wang Qinzhou, Liu Hongen, Wu William K. K., Chan Matthew T.V.
期刊名稱Current Opinion in Anaesthesiology
出版年份2017
月份10
卷號30
期次5
頁次557 - 562
國際標準期刊號0952-7907
語言英式英語
關鍵詞intraoperative neurophysiology monitoring, motor evoked potential, postoperative neurological outcome,
somatosensory evoked potential, warning criteria

上次更新時間 2020-28-11 於 01:53