Jean-Michel Guérit1, Robert A Dion. 1. Cliniques Universitaires St-Luc, Catholic University of Louvain, Brussels, Belgium. guerit@nchm.ucl.ac.be
Abstract
BACKGROUND: The prevention of immediate and delayed paraplegia after thoracoabdominal aorta surgery relies on hemodynamic maneuvers (aimed at restoration of an adequate spinal cord perfusion pressure) and cytoprotective measures (hypothermia, drugs). METHODS: The indications for implementing these measures can be provided by motor-evoked potential (MEP) or somatosensory-evoked potential (SEP) monitoring. RESULTS: Intraoperative interactions between the surgeon and the neurophysiologist can be described by algorithms to be applied in the presence or absence of intraoperative MEP or SEP changes. CONCLUSIONS: It should be noted that normal SEPs or MEPs at the end of surgery do not systematically guarantee the nonoccurrence of delayed paraplegia, especially when segmental arteries have been ligated, in which case postoperative SEP monitoring is indicated.
BACKGROUND: The prevention of immediate and delayed paraplegia after thoracoabdominal aorta surgery relies on hemodynamic maneuvers (aimed at restoration of an adequate spinal cord perfusion pressure) and cytoprotective measures (hypothermia, drugs). METHODS: The indications for implementing these measures can be provided by motor-evoked potential (MEP) or somatosensory-evoked potential (SEP) monitoring. RESULTS: Intraoperative interactions between the surgeon and the neurophysiologist can be described by algorithms to be applied in the presence or absence of intraoperative MEP or SEP changes. CONCLUSIONS: It should be noted that normal SEPs or MEPs at the end of surgery do not systematically guarantee the nonoccurrence of delayed paraplegia, especially when segmental arteries have been ligated, in which case postoperative SEP monitoring is indicated.
Authors: Lorenzo Rossi; Anna Maria Bianchi; Anna Merzagora; Alberto Gaggiani; Sergio Cerutti; Francesco Bracchi Journal: Biomed Eng Online Date: 2007-01-04 Impact factor: 2.819
Authors: Fabian I Kerkhof; Jan van Schaik; Richard A Massaad; Catharina S P van Rijswijk; Martijn R Tannemaat Journal: Clin Neurophysiol Pract Date: 2020-12-11