Parthiban, K Velayutham (2008) Intraoperative Monitoring of patients during Neurosurgical Procedures: A Biochemical and Electrophysiological study. Doctoral thesis, The Tamilnadu Dr. M.G.R. Medical University, Chennai.
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Abstract
Intraoperative electrophysiological monitoring of the nervous system is used to prevent complications arising during the course of neurosurgical procedures. Various electrophysiological monitoring techniques such as EEG (Electroencephalogram), EP (evoked potentials), EMG (Electromyography) and NCV (Nerve conduction velocity) are used during the course of surgery. The principal goal of intraoperative electrophysiological monitoring is prompt identification of nervous system impairment during surgery and prevent permanent postoperative deficits provide relative reassurance to the surgeon that no identifiable complication has been detected up to that point, allowing the surgeon to proceed further and provide a more thorough or careful surgical intervention than would have been provided in the absence of monitoring modify surgical strategy when any change occurs in the recordings. CONCLUSIONS: Our study shows that intraoperative neurophysiologial monitoring needed specific care and attention during the course of surgery to avoid the permanent postoperative neurological deteriorations. The study also concludes that (1) Usage of multipulse stimulation and multiple sweeps of stimulation (0.7Hz) is very effective in eliciting iMEPs. More studies need to be done to understand this phenomenon. (2) Averaging of these responses can used for more consistent responses. (3) Intravenous anaesthesia (propofol) is more ideal than inhalational anaesthesia (isoflurane) for iMEPs. (4) It is important to monitor more than one muscle to predict postoperative outcome. (5) Pain is the main cause for intraoperative hypertension and it is mediated by increased norepinephrine levels in the circulation. (6) Intraoperative maintenance of stable haemodynamics by pre-emptive therapy with lisinopril (angiotensin converting enzyme inhibitor) would be beneficial and prevent the intraoperative associated postoperative neurological complications. This is particularly important if the patient requires intraoperative neurophysiological monitoring.
| Item Type: | Thesis (Doctoral) |
|---|---|
| Uncontrolled Keywords: | Intraoperative monitoring, neurosurgery, Biochemical, Electrophysiological study. |
| Subjects: | Respiratory Medicine > Neurology > Respiratory Medicine > Neurology |
| Depositing User: | Devi S |
| Date Deposited: | 21 Jun 2017 09:34 |
| Last Modified: | 11 Sep 2022 05:02 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/182 |
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