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Intro -- Preface -- Acknowledgments -- Contents -- Contributors -- Part I: Monitoring Techniques -- 1: Somatosensory-Evoked Potentials -- Introduction -- Anatomy and Vascular Supply -- Methods -- Stimulation -- Recording -- Intraoperative Variables Affecting SSEPS: Pharmacology and Physiology -- Inhalational Anesthetics -- Intravenous Anesthetics -- Temperature -- Tissue Perfusion -- Oxygenation/Ventilation -- Intracranial Pressure -- Other Physiologic Variables -- Criteria for Intervention During Intraoperative SSEP Monitoring -- Dorsal Column Mapping -- Other Intraoperative Applications for SSEPs -- References -- 2: Transcranial Motor-Evoked Potentials -- Introduction -- Anatomy of the MEP Response -- Technical Aspects of MEP Monitoring -- Optimizing Compound Muscle Action Potential -- Patient Characteristics Contributing to Outcomes -- Effect of Anesthesia Management -- Outcomes -- Conclusion -- References -- 3: Auditory-Evoked Potentials -- Anatomy of the Auditory System -- Conduction of Auditory Signals from Ear to Cochlea -- Neural Components of the Auditory System and Electrical Generators Along the Auditory Pathway -- Cochlea: Electrocochleogram -- Auditory Pathway from Cochlear Nerve to Midbrain -- Auditory Brainstem-Evoked Responses and Cochlear Nerve Compound Action Potential -- Primary Auditory Cortex: Mid-Latency Auditory-Evoked Potentials -- Vascular Supply of Auditory Pathway Structures -- Techniques for Recording Auditory-Evoked Potentials -- Stimulation -- Electrocochleogram -- Compound Nerve Action Potentials from the Cochlear Nerve -- Brainstem Auditory-Evoked Potentials -- MLAEPs -- Anesthetic and Physiologic Considerations for Monitoring of Auditory Brainstem Responses -- ABR Alarm Criteria -- References -- 4: Visual-Evoked Potentials -- Introduction -- Flash Electroretinogram (F-ERG).
Flash Visual-Evoked Potentials (F-VEPs) -- Introduction of the Intraoperative Monitoring of the Visual System: Orbital Surgeries -- Identified Sources of Intraoperative Variations in F-VEPs -- Recognition of a Reliable Monitoring of Vision -- Anatomy and Physiology of the Visual System -- Realization of Intraoperative Electroretinogram (ERG) and Flash Visual-Evoked Potentials (F-VEPs) -- Intraoperative ERG -- Intraoperative F-VEP -- Devices for Flash Stimulation -- Characteristics of Stimulation Light -- ERG Recordings and Analyses -- F-VEP Recordings and Analyses -- Warning Criteria -- Warning Criteria for ERGs -- Warning Criteria for F-VEPs -- Other Intraoperative Applications with ERG and F-VEP: Cardiovascular Surgeries, Deep Brain Stimulation -- Direct Electrical Stimulation of Visual Pathway -- Effects of Temperature -- Effects of Anesthesia on ERGs -- Effects of Anesthesia on F-VEPs -- Conclusion -- References -- 5: Deep Brain Stimulation -- Introduction -- Surgery -- Microelectrode Recording (MER) -- Complications -- Asleep vs. Awake Surgery -- The MER Procedure -- Target Structures for the Case Examples -- Cases and Disorders -- Case 1: Routine DBS of the STN in Parkinson's Disease -- Clinical Symptoms of PD -- Parkinson's Disease -- Procedure and Decisions -- Case 2: Noncomplex (PD-STN, Asleep) -- Preoperative Evaluation -- Procedure and Decisions -- Case 3: Complex -- Dystonia -- Procedure and Decisions -- Case 4: Complex -- Status Dystonicus -- Procedure and Decisions -- Conclusion -- References -- 6: Intraoperative Electromyography -- General Principles of EMG -- Anatomy of the Lower Motor Neuron System -- Motor Unit -- Neuromuscular Junction -- Anesthesia Considerations for EMG -- Neuromuscular Blocking Agents -- Local Anesthetic Agents -- Anesthesia for Other Myogenic Modalities -- Train-of-Four Technique.
Common Troubleshooting Issues in Train-of-Four -- Clipping -- Misinterpretation of Train-of-Four Data and Stimulus Artifact -- Spontaneous EMG-Fundamental Principles -- Neuronal Axons Respond to Mechanical Stimuli -- Neuronal Axons Respond to Thermal Stimuli -- Recording Electrode Considerations -- Electrode Type -- Location and Spacing -- Electrode Configuration -- EMG Recording Parameters -- Recording Sweep (Time Base) -- Filters -- Sensitivity -- Use of Audio Feedback -- Audio Feedback -- Audio Squelch or Muting -- Patterns of Iatrogenic EMG Activity -- Differential Diagnosis for EMG Activity -- "Light" Anesthesia -- Patient Positioning -- Thermal Induced EMG from Irrigation -- Artifact and Electrical Noise -- Triggered EMG-Fundamental Principles -- Stimulus Configurations: Monopolar Versus Bipolar -- Stimulus Artifact in Triggered EMG -- EMG Application and Technique for Cranial Nerves -- Electrode Placement for Cranial Nerves -- Cranial Nerves III, IV, and VI -- Cranial Nerves V and VII -- Cranial Nerves IX, X, XI, and XII -- Glossopharyngeal Nerve-CNIX -- Vagus Nerve-CNX -- Spinal Accessory Nerve-CNXI -- Hypoglossal Nerve-CN XII -- Stimulus and Recording Parameters and Technique for Triggered Cranial Nerve EMG -- Stimulus Intensity for Cranial Nerves -- Intracranial Cranial Nerve Stimulation -- Extracranial Cranial Nerve Stimulation -- Stimulating Dissectors -- Safety Issues with Cranial Nerve Stimulation -- Cranial Nerve Identification with Triggered EMG -- Using Triggered EMG to Evaluate Facial Nerve Function After Acoustic Neuroma Surgery -- Mapping the Floor of the Fourth Ventricle -- Mapping Technique -- Triggered EMG Application in Thyroid Surgery -- Factors Causing Amplitude and/or Latency Changes in Vagus Nerve CMAP -- EMG Applications and Technique in Spinal Procedures -- Recommended Recording and Stimulating Parameters for Spinal EMG.
Electrode and Montage Considerations for Spinal EMG -- EMG Electrode Placements According to Vertebral Levels Involved in the Surgery -- Assessing Nerve Root Function and Pedicle Screw Placement -- Description of Pedicle Screw Stimulation Technique -- Stimulus Setup -- Stimulation -- Automated Thresholding -- Sources of False-Negative Screw Thresholds -- Summary of Factors that May Falsely Increase Thresholds -- Sources of False Positive Screw Thresholds -- Minimally Invasive Lateral Transpsoas Approach to the Spine -- Technique for Triggered EMG during the Lateral Transpsoas Approach -- Cauda Equina Surgery -- Selective Dorsal Rhizotomy -- Suprasegmentally Generated EMG Discharges (SEDs) -- References -- 7: The Use of Spinal Reflex Responses for IOM -- Introduction -- Anatomy and Neurophysiology -- Spinal Cord Pathophysiology -- Spinal Nerve Root Pathophysiology -- Late Responses -- F-Responses -- F-Response Facilitation-Interaction Technique -- A-Waves -- H-Reflexes: Monosynaptic, Oligosynaptic -- Neurophysiologic Basis of H-Reflexes -- Gastrocnemius H-Reflex -- Gastrocnemius H-Reflex Normal Parameters -- Gastrocnemius H-Reflex Stimulation and Recording Techniques -- Flexor Carpi Radialis H-Reflex -- Flexor Carpi Radialis H-Reflex Background and Normal Parameters -- Flexor Carpi Radialis H-Reflex Stimulation and Recording Techniques -- Anesthetic Effects on Spinal Cord CPGs -- Clinical Correlation of H-Reflexes and F-Responses -- Clinical Correlation Summary -- H-Reflex Facilitation-Interaction Techniques -- Polysynaptic Reflexes -- Sacral Reflex -- Intraoperative Application of BCRs -- Monosynaptic and Polysynaptic Reflexes: Selective Dorsal and Ventral Root Rhizotomy -- Background -- Technical Summary -- Lower Extremity Intralimb and Interlimb Polysynaptic Reflexes -- Conclusion -- References -- 8: Brainstem Reflexes Under General Anesthesia.
Introduction -- Effects of General Anesthesia on Brainstem Centers -- Anatomy and Physiology of Specific Brainstem Reflexes Under General Anesthesia -- Blink Reflex -- H-Masseter -- Laryngeal Adductor Reflex (LAR) -- Methodologies for Eliciting Brainstem Reflexes Under General Anesthesia -- Blink Reflex -- H-Masseter -- Laryngeal Adductor Reflex (LAR) -- Contribution of Anesthesiology to Successfully Monitor Brainstem Reflexes -- Correlation of Brainstem Reflexes Monitoring with Postoperative Outcome -- Conclusion -- References -- 9: Brain Mapping: Asleep and Awake -- Introduction -- Planning -- Presurgical Mapping -- Planning of the Intraoperative Mapping Procedure -- Language and Parietal Mapping and Monitoring During Awake Craniotomies -- Establishing Baselines -- The Mapping Strategy -- Continuous Monitoring of Language or Parietal Functions -- Subcortical Mapping -- Ictal Events -- Location of the Central Sulcus by Median SSEP Phase Reversal Technique -- Motor Mapping via Electrical Stimulation with the Penfield Paradigm -- Motor Mapping and Monitoring via Electrical Stimulation with the Multipulse Train Paradigm -- Subcortical Motor Mapping -- Protection of the Thalamocortical Input to the Peri-Rolandic Region -- Electrocorticography (ECoG) in Functional Mapping -- Conclusions -- References -- 10: Intraoperative Monitoring of EEG and Processed EEG -- Introduction -- The Genesis of the EEG -- Cytoarchitecture -- Control of Rhythm and Anesthesia-Induced Sedation and Loss of Consciousness -- EEG Signal -- Time-Domain Method -- Frequency-Domain Methods -- Raw and Processed EEG -- Anesthetic Drugs Impact on EEG -- Propofol and Barbiturates -- Benzodiazepines -- Ketamine -- Dexmedetomidine -- Opioids -- Volatile Agents -- Nitrous Oxide -- Muscle Relaxants -- Clinical Utility of Raw and Processed EEG -- Future Directions of EEG Monitoring.
Conclusion.
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Info
J.E.P.U 2016 : Le risque cardiaque en anesthésie, Consensus et controverses en anesthésie, L'enseignement par simulation / / P. Coriat, N. Fleury, S. Lamy
