1st Edition
A Concise Guide to Intraoperative Monitoring
Covering both the applications and the related theory, A Concise Guide to Intraoperative Monitoring provides a general but comprehensive introduction to IOM. Unlike existing texts that typically report the results of specific studies, this book presents comprehensive coverage of the entire procedure, as well as the specific protocols used in hospital practice, examples of typical recordings, possible problems, and recommended solutions. At the end of each chapter the author poses several questions for review. These questions help technologists and medical residents in their preparation for the board exams. Taken together, these features make the book an ideal reference or training manual.
A Concise Guide to Intraoperative Monitoring begins by discussing the basic principles underlying the generation of bioelectrical signals. It then describes the electronic equipment and the various electrophysiological procedures involved in IOM. From this foundation, the book gradually advances to more specific topics, such as surgical procedures, neuronal structures at risk, the optimum combinations of tests to administer, and the proper interpretation of test results. The material
also provides you with a background on general anesthesia and analyzes the effects of various drugs on electrophysiological recordings. A Concise Guide to Intraoperative Monitoring also discusses the proper placement of stimulation and recording electrodes, as well as intervention strategies and equipment troubleshooting.
LIST OF TABLES
INTRODUCTION
Intraoperative Monitoring
Use
Rationale
Types of Tests
Affecting Factors
Interpretation
Usefulness
Cost Effectiveness
Personnel
Equipment
Organization of the Book
Review Questions
NEUROPHYSIOLOGICAL BACKGROUND
Organization of the Human Body
Origin of Neurophysiological Signals
Spontaneous Activity
Evoked Responses
INSTRUMENTATION
Basic concepts
Electrodes
Types of Stimulation Electrodes
Types of Recording Electrodes
Amplifiers
Differential Amplifiers
Amplifier Characteristics
ELECTROPHYSIOLOGICAL RECORDINGS
Signal Characteristics
Frequency Analysis
Data Processing
Data Display
Data Storage
ANESTHESIA MANAGEMENT
Components of Anesthesia
Efficacy of Anesthetics
Inhalational Anesthetics
Intravenous Anesthetics
Neuroprotective Agents
Protective Induced conditions
Effects on Neurophysiological Signals
SPONTANEOUS ACTIVITY
Electroencephalogram
Electromyogram
EVOKED ACTIVITY
Evoked Potentials
Somatosensory Evoked Potentials
DSEPs
Brainstem Auditory Evoked Responses
Visual Evoked Potentials
Motor Evoked Potentials
Triggered EMG
SPINE SURGERY
Spinal Deformities
Disc Disease
Spinal Fractures and Instabilities
Tumors
Vascular Abnormalities
Tethered Cord
Selective Dorsal Rhizotomy
Peripheral Nerve Monitoring
CRANIAL SURGERY
Surgery for Tumor Removal
Neurovascular Procedures
Cranial Nerve Surgery
Endarterectomy
Neuroradiological Procedures
Central sulcus Localizaion
ARTIFACTS & TROUBLESHOOTING
Efficacy of Monitoring
Artifacts
Precautions
Troubleshooting
Intervention
The Wake-up Test
CLOSING REMARKS
REFERENCES
FURTHER READING
NOTE: Introduction and Review Questions start and end each chapter.
Biography
George Zouridakis, Andrew C. Papanicolaou