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Intraoperative Monitoring During Neurosurgical Procedures and Patient Outcomes

  • Patient Safety in Anesthesia (SJ Brull and JR Renew, Section Editors)
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Abstract

Purpose of Review

Although intraoperative neuromonitoring has become a standardized practice for many neurological procedures, the evidence supporting its benefit remains contradictory. Here, we summarize the latest evidence of the impact of neuromonitoring on patient outcomes and make recommendations on its use in neurosurgery.

Recent Findings

Despite some conflicting literature regarding its accuracy in predicting neurological outcomes, current guidelines support the use of intraoperative monitoring in neurosurgery for specific high-risk procedures. Recent studies suggest that using several monitoring modalities, whether unimodally or multimodally, are associated with high sensitivity and specificity for predicting neurological injury in high-risk neurosurgical procedures.

Summary

Despite inconclusive evidence regarding the routine use of neuromonitoring modalities for spine and brain surgery, there is clear support to recommend neuromonitoring use during high-risk procedures and in patients with specific considerations. All neuromonitoring modalities provide valuable information that should be considered during the surgical decision-making process; however, the information provided by these modalities should not be considered solely diagnostic and should be viewed in the context of other supporting data.

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  1. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA

    Benjamin F. Gruenbaum, Alejandro J. Hallo Carrasco & Shaun E. Gruenbaum

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  1. Benjamin F. Gruenbaum
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Gruenbaum, B.F., Hallo Carrasco, A.J. & Gruenbaum, S.E. Intraoperative Monitoring During Neurosurgical Procedures and Patient Outcomes. Curr Anesthesiol Rep 12, 484–492 (2022). https://doi.org/10.1007/s40140-022-00542-0

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