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At least 325 records · Page 18Linked to original sources
PubMed1995

Choice of anesthesia and intraoperative monitoring for lower extremity revascularization.

The prevalence of significant coronary artery disease re-enforces the importance of careful preoperative and intraoperative management in patients undergoing lower extremity revascularization. This article presents a practical approach toward the evaluation of anesthetic risk and the proper use of anesthetic agents and monitoring devices to minimize morbidity. The role of general and regional anesthetic agents is discussed, and complications of both techniques are presented.

Anesthesia↗
PubMed2002

[Intraoperative monitoring of transcranial hemodynamics in gerontological patients under general anesthesia in abdominal surgeries].

The efficiency of up-to-date medical technologies is closely related to the development of methods and tools of objective control over the patients' state in the process of treatment. The problem of continuous control over diagnostic information occupies a special place in the medicine of critical states, since the monitoring of the patient's current state can be of vital importance. The development of tools for the monitoring of the patients' state is based on the recording of physiological data and their further evaluation with the purpose of determination of indices characterizing the operation of the most important systems of the organism.

Abdomen↗
PubMed1989

Intraoperative monitoring of brainstem auditory evoked potentials following emergency evacuation of a cerebellar vascular malformation.

This case report highlights the use and value of monitoring the auditory brainstem response during emergency neurosurgery. The prompt on-line changes in the auditory brainstem response after evacuation of a cerebellar arteriovenous malformation provided objective evidence of improved brainstem function, which aided in the management of this patient's disorder.

Adult↗
PubMed1988

Simultaneous recording of noninvasive ECoG and ABR for use in intraoperative monitoring.

Monitoring auditory evoked potentials, especially surface recorded responses (ABR), during neuro-otologic surgery is being widely used. Recording of the most peripheral components of the ABR with surface electrodes can be difficult, however, in patients with hearing loss. To enhance wave I, a newly designed canal electrode for noninvasive electrocochleography (ECoG) has been used. A small reticulated foam plug is inserted in the ear canal and serves as the electrode. The signal is transduced through a center polyethylene tube. The advantages of this system for ECoG are several: (1) simplified signal presentation, obviating the need for custom ear mold or button transducer; (2) large electrode surface area that lowers impedance and improves signal to noise ratio; and (3) stability of the electrode during manipulations within the surgical field. There are several advantages to supplementing ABR with simultaneous ECoG. First, there is a significant enhancement in wave I amplitude, an important factor when monitoring from hearing impaired patients in an operating room environment. Ability to clearly define wave I permits use of the I-V interwave interval, which can be a more sensitive parameter than wave V latency alone. Secondly, more rapid feedback on changes in cochlear function is available since, compared to surface recordings alone, fewer responses need to be averaged.

Audiometry, Evoked Response↗
PubMedDate not supplied

Intraoperative monitoring and use of the internal shunt during carotid endarterectomy.

Carotid endarterectomy can be an effective form of therapy in stroke prevention in patients with carotid artery disease. A perioperative stroke is not only a devastating complication but negates the beneficial effects of the procedure. Careful attention to detail will prevent embolization during carotid endarterectomy and thus avoid the most common cause of perioperative cerebral infarction. The maintenance of adequate cerebral perfusion during carotid endarterectomy can be provided with the use of a shunt during carotid cross-clamping. This is necessary in approximately 15% of patients. Different approaches to the use of a shunt during carotid endarterectomy are discussed with their merits and disadvantages. Assessment of the technical results prior to completion of the operation should be an integral part of the procedure. The available methods, with their inherent limitations, are briefly discussed.

Angiography↗
PubMed1989

Clinical evaluation of the augmented delta quotient monitor for intraoperative electroencephalographic monitoring of children during surgery and cardiopulmonary bypass for repair of congenital cardiac defects.

To assess the augmented delta quotient (ADQ) monitor as a monitor of cerebral function during cardiac surgery, we monitored during operation the electroencephalograms of 48 young subjects (aged 2 weeks to 19 yr). We found ADQ patterns produced by cardiopulmonary bypass, hypothermia and general anaesthetic agents correlated with those obtained from a compressed spectral array (CSA) monitor and could be differentiated from changes caused by cerebral ischaemia, except in the youngest group of patients (less than or equal to 18 months) undergoing deep hypothermia (19.4 (SD 0.8) degrees C nasopharyngeal). In all other age groups the ADQ proved to be a simple monitor of the adequacy of cerebral perfusion. Neurological deficit occurred only if the ADQ was abnormal during hypotension for a period exceeding 7 min. ADQ evaluation of cerebral function was limited by events which produced artificially normal ADQ readings such as low amplitude EEG activity and the described isoflurane effect that was demonstrated to occur in some cardiac patients. The results obtained by the ADQ were comparable to those obtained by compressed spectral array and the ADQ was easier to use and interpret.

Adolescent↗
PubMed1992

Intraoperative monitoring of the dorsal sacral roots: minimizing the risk of iatrogenic micturition disorders.

In 31 children (age, 2-17 years) and 1 adult, individual dorsal root action potentials (DRAPs) from the S1-S3 roots were recorded intraoperatively after electrical stimulation of the dorsal penile or clitoral nerves, in preparation for surgery within the cauda equina. In most patients, pudendal afferent activity was present in S2 and S3 bilaterally; in some, the afferent activity was confined to a single root bilaterally, and in one, to a single root on one side. Dorsal root action potentials of small amplitude were recorded from S1 in 15 patients, although in no patient was S1 the primary carrier of these afferents. No lesion of the roots or rootlets carrying significant afferent activity was created during the rhizotomy, and no dysfunction in micturition resulted. We propose that the neurophysiological identification of roots and rootlets carrying afferent activity from the penile or clitoral nerves allows for rhizotomy of the S2 roots with the least possible risk of postoperative micturition and sexual dysfunction.

Adolescent↗
PubMed1988

Intraoperative monitoring of the facial nerve.

Anatomic preservation of the facial nerve, with maximal facial function, is one of the goals of acoustic neuroma surgery. Application of electrophysiologic monitoring techniques is useful in achieving this goal. Preoperative electromyography and nerve conduction studies provide important prognostic information for preservation of the nerve and postoperative function. Intraoperative electromyography alerts the surgeon to facial nerve proximity and potential injury. Direct nerve stimulation is utilized to confirm the location and integrity of the nerve. Matched-pair analysis of two groups of patients demonstrated an increased ability to preserve the facial nerve with less postoperative facial deformity.

Adolescent↗
PubMed2005

Intraoperative monitoring of penile and buttock blood flow during endovascular abdominal aortic aneurysm repair.

OBJECTIVE: The purpose of this study was to assess the pelvic circulation during endovascular abdominal aortic aneurysm repair (EVAR) with a new monitoring system measuring penile and buttock blood flow. METHODS: We measured penile brachial pressure index (PBI) during EVAR by pulse-volume-plethysmography (form PWV/ABItrade mark). We also measured bilateral gluteal tissue oxygen metabolism with near-infrared spectroscopy to provide a gluteal tissue oxygenation index (TOI). Twenty-two men who underwent aortouni-iliac stentgraft with crossover bypass for exclusion of abdominal aortic aneurysm were studied. Twelve patients underwent aorto-uni-common iliac artery stentgraft (CIA) and ten underwent aorto-uni-external iliac artery stentgraft (EIA). RESULTS: In all patients, there was an immediate reduction in PBI during the EVAR procedure. After revascularization of the ipsilateral limb of the stent graft, the recovery of PBI was significantly less in EIA group. After the completion of crossover bypass, PBI in both groups recovered to the baseline values. In both groups there was a bilateral reduction in gluteal TOI during malperfusion of the internal iliac artery. After revascularization of ipsilateral limb of the stent graft, the ipsilateral TOI recovered to the baseline level in CIA patients, but recovery was incomplete in EIA patients. In contrast, contra-lateral TOI remained low in both groups after revascularization of ipsilateral limb of the stent graft. Only after completion of crossover bypass did the contra-lateral TOI recover to baseline level in both groups. CONCLUSIONS: Both TOI at the buttocks and PBI are a sensitive reflection of pelvic haemodynamics. Penile blood flow and bilateral gluteal blood flow are supplied via different circulations and both should be monitored for full assessment of the pelvic circulation.

Aged↗
PubMedDate not supplied

Intraoperative monitoring of the liver transplant patient.

The undertaking of liver transplantation requires a very high level of invasive hemodynamic and laboratory monitoring. The initial state of the patient and the possibility of massive hemorrhage make well-organized protocols for the speedy return of larger amounts of data essential. Rehearsal of the protocols will identify any deficiencies. In our case, we used trauma patients with potentially exsanguinating massive hemorrhage. The development of these protocols is useful both for intraoperative management of hepatic transplantation and trauma patients. Biochemical testing should be given prioritization, paper work kept to a minimum, and specific testing standardized. A dedicated person is needed in the operating room to handle samples and data, and probably a dedicated telephone as well.

Blood Coagulation Tests↗