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Peripheral Nerve Monitoring

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Principles of Neurophysiological Assessment, Mapping, and Monitoring

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Abstract

The peripheral nervous system is comprised of a complex and vast network of nerves that work synergistically to achieve unique functions in the human body. Neuronal diversity lends nerves in this system to be vulnerable to a variety of injury types that have different management strategies. Peripheral nerve monitoring has been proven to be a useful asset for intraoperative management of nerve lesions. Physical examination alone of nerve lesions has been shown to be an unreliable and often misleading method to assess nerve integrity and regeneration. Intraoperative peripheral nerve assessment provides clinicians with unique, real-time information that is otherwise unavailable via preoperative nerve examination. This additional information can help to guide clinical decision-making and subsequently improve patient outcomes. This chapter will provide a brief overview of the physiology and anatomy of the peripheral nervous system, review nerve injury classifications, and detail the equipment and techniques utilized for effective intraoperative peripheral nerve assessment.

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Author information

Authors and Affiliations

  1. Emory University School of Medicine, Department of Anesthesiology, Division of Critical Care, Atlanta, GA, USA

    Amit Prabhakar

  2. University Medical Center New Orleans, Department of Anesthesiology, New Orleans, LA, USA

    Kenneth Mancuso

  3. Department of Anesthesiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Jonathan Lissauer

  4. Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU School of Medicine, Shreveport, LA, USA

    Alan David Kaye

  5. LSU School of Medicine, Department of Anesthesiology, New Orleans, LA, USA

    Alan David Kaye

  6. Tulane School of Medicine, New Orleans, LA, USA

    Alan David Kaye

  7. Department of Anesthesiology, Louisiana State University School of Medicine, Tulane University School of Medicine, New Orleans, LA, USA

    Scott Francis Davis

Authors
  1. Amit Prabhakar
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  2. Kenneth Mancuso
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  3. Jonathan Lissauer
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  4. Alan David Kaye
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  5. Scott Francis Davis
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Editor information

Editors and Affiliations

  1. Department of Anesthesiology, Louisiana State University School of Medicine, Tulane University School of Medicine, New Orleans, LA, USA

    Scott Francis Davis

  2. Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU School of Medicine, Shreveport, LA, USA

    Alan David Kaye

Review Questions

Review Questions

  1. 1.

    Discuss the five Sunderland grades of nerve injury.

  2. 2.

    What is the advantage of using tripolar hook electrodes for stimulation?

  3. 3.

    What can be inferred from an observed latency increase in NAPs?

  4. 4.

    Define and describe Wallerian degeneration.

  5. 5.

    What are the different nerve fiber types and how do their conduction velocities differ?

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Prabhakar, A., Mancuso, K., Lissauer, J., Kaye, A.D., Davis, S.F. (2020). Peripheral Nerve Monitoring. In: Davis, S., Kaye, A. (eds) Principles of Neurophysiological Assessment, Mapping, and Monitoring. Springer, Cham. https://doi.org/10.1007/978-3-030-22400-4_17

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  • DOI: https://doi.org/10.1007/978-3-030-22400-4_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-22399-1

  • Online ISBN: 978-3-030-22400-4

  • eBook Packages: MedicineMedicine (R0)

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