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Results for “Monitoring, Intraoperative”

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At least 73 records · Page 4Linked to original sources
PubMed2006

Non-invasive intraoperative monitoring of blood pressure and arterial pCO2 during surgical anesthesia in mice.

Despite the constantly increasing use of genetically engineered mice in biomedical research, control of crucial physiological parameters such as blood pressure and arterial blood gases is difficult to achieve in temporarily anesthetized mice due to lack of techniques for reversible arterial cannulation. Here we report that arterial blood pressure and blood gases can be measured reliably in anaesthetized and artificially ventilated mice using non-invasive technology. C57Bl6 mice were anaesthetized by i.p. injection of midazolam, fentanyl, and medetomidin, intubated, and ventilated for 3h. End tidal pCO2 was monitored by micro-capnometry. Arterial blood pressure was measured non-invasively using a tail cuff. Non-invasive blood pressure (NIBP) correlated strongly with the invasive arterial blood pressure measured at the external carotid artery (r = 0.99, P < 0.001) and end tidal pCO2 values correlated very well with arterial blood pCO2 (r = 0.93, P < 0.001). The current results demonstrate that it is possible to reliably measure and control the most relevant physiological parameters in anesthetized mice. Thereby the current study may help to reduce animal numbers and perform mice experiments under more defined and controlled physiological conditions in the future.

Anesthesia↗
PubMed2006

Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system.

BACKGROUND: Cerebrovascular reconstruction procedures run the risk of changing the balance between oxygen supply and consumption during surgery. We assessed the value of visual light spectroscopy for detecting changes in cerebral blood oxygenation (CBO) during superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. METHODS: We developed a VLS monitoring system which permits continuous monitoring of CBO changes during surgery. Using the VLS, we evaluated the CBO changes in the MCA territory on the lesion side in 18 patients who underwent STA-MCA anastomosis. RESULTS: Temporary occlusion of the MCA (M4 portion) did not change the CBO in 17 patients. However, in the patient with dissecting aneurysm, it caused decreases of oxyhemoglobin and cortical oxygen saturation (CoSo(2)) associated with an increase of deoxyhemoglobin, although these CBO changes were normalized by STA blood flow. In 5 patients, STA blood flow increased the oxyhemoglobin and CoSo(2) and decreased the deoxyhemoglobin, indicating that cortical blood flow (CoBF) was increased. The CoSo(2) before anastomosis was significantly low in the patients who showed an increase of CoSo(2) by STA blood flow (63.0% +/- 2.5%) as compared with those who did not (72.0 +/- 6.1%, P = .024). CONCLUSION: Temporary occlusion of a cortical artery during bypass surgery did not affect the CBO in patients who had chronic cerebral ischemia, but caused acute ischemia in the patient who did not. STA blood flow increased the CoBF during surgery more frequently in patients who showed a low perfusion pressure. The VLS monitoring system is considered useful for evaluating bypass function and facilitates safe and accurate bypass surgery.

Adolescent↗
PubMed1997

Intraoperative monitoring of IMA flow: what does it mean?

BACKGROUND: This study examines whether the measurement of internal thoracic artery (ITA) graft flow can determine the adequacy of the ITA-left anterior descending coronary artery (LAD) anastomosis. METHODS: To study a wide range of clinical problems, we used a computer simulation of the cardiovascular system. The model included a time-varying elastance model of the heart, a systemic circulation represented by a multielement nonlinear model of the aorta and its major branches, a nonlinear model of the LAD circulation, and a model of the ITA bypass graft. RESULTS: With a mild LAD stenosis, ITA graft flow was low and flow reversal occurred. As the percent stenosis increased, ITA flow and the percentage of ITA-to-total LAD flow increased. The ITA graft helped to maintain resting LAD blood flow. A partial obstruction (40%) at the ITA-LAD anastomosis reduced ITA graft flow at similar levels of LAD stenosis. However, overlap in flow values comparing a normal with a partially obstructed anastomosis occurred. CONCLUSIONS: Flow patterns in the ITA are highly dependent on the degree of stenosis of the LAD as well as the integrity of the anastomosis. The predictive power of ITA flow measurement increases with severe stenosis or total occlusion of the proximal LAD and with high coronary blood flow demands.

Anastomosis, Surgical↗
PubMed2004

Electrophysiologic intraoperative monitoring for spine procedures.

The advent of equipment capable of performing SEPs, MEPs, and EMG in a multiplexed manner and in a timely fashion brings a new level of monitoring that far exceeds the previous basic monitoring done with SEPs only. Whether this more comprehensive monitoring will result in greater protection of the nervous system awaits future analysis. In any event, monitoring of the spinal cord with SEPs is an accepted standard of care for cases that place the spinal cord at risk. Likewise, nerve root monitoring with EMG is a widely practiced form of monitoring and shows great benefit. MEPs and reflex monitoring, which address the descending pathways and the interneuronal connections, is efficacious in detecting abnormalities that may be missed by SEPs.

Electromyography↗
PubMed1991

Intraoperative monitoring for tethered spinal cord syndrome.

Functions of the lower extremities and bowel and bladder must be monitored during releasing surgery for tethered spinal cord syndrome, because neural elements are embedded in lipoma or anomalous tissues. Evoked muscle action potentials of the external anal sphincter muscle, external urethral sphincter muscle, and lower extremity muscles can indicate promptly whether or not neural elements are involved before the surgeon releases or cuts the tissue for cord release. It is also important to monitor vesical pressure because of different types of innervation from the external urethral and anal sphincters, in spite of slow reaction times of vesical pressure elevation. Evoked muscle action potentials indicate only motor function; therefore, it is more appropriate to record evoked spinal cord potentials from the spinal cord above a lumbosacral operative field, because sensory function can also be monitored. Evoked muscle action potentials are an easy and extremely sensitive monitoring system; nevertheless, monitoring of vesical pressure and evoked spinal cord potentials should also be done to achieve optimum monitoring. For the past 5 years, 10 patients have undergone cord-release surgery with such a monitoring system, and the results indicate no exacerbating case.

Adolescent↗
PubMed2006

The effects of volatile anesthetics on intraoperative monitoring of myogenic motor-evoked potentials to transcranial electrical stimulation and on partial neuromuscular blockade during propofol/fentanyl/nitrous oxide anesthesia in humans.

The aim of the present study was to compare the influence of volatile anesthetics on transcranial motor-evoked potentials (tcMEP) in humans anesthetized with propofol/fentanyl/nitrous oxide and on partial neuromuscular blockade (NMB). The authors studied 35 ASA I and II patients who were undergoing elective craniotomy and brain tumor resection. The patients were randomized to one of three groups to receive halothane (HAL), isoflurane (ISO), or sevoflurane (SEV). Anesthetic depth was initially adjusted using the bispectral index to 40+/-5, and NMB was adjusted to 40%-50% of one twitch of train of four (T1) after recovery from intubation. MEPs with train of five square-wave pulses were elicited using screw electrodes placed in the skull over C3-C4. After craniotomy, the inhalational agent was introduced at 0.5 MAC and then 1.0 MAC (20 minutes each), and the effects on MEPs, NMB, and hemodynamic variables were studied. A decrease in BIS and systolic blood pressure was observed with all agents. Both SEV and ISO at 1.0 MAC significantly decreased train-of-four ratio from 38.4+/-18.1 at control to 19.0+/-9.7 and from 35.3+/-12.4 to 26.1+/-13.7, respectively (P<0.001), but not HAL at 1.0 MAC. The amplitudes of tcMEPs were significantly reduced by all agents at 1.0 MAC, with the effect being less in HAL at 0.5 MAC. We have shown that HAL had a lesser suppressive effect on MEPs than either ISO or SEV at 0.5 MAC, which was partially due to a lesser degree of NMB.

Adult↗