Neuromonitoring in High Risk Surgery: Physiological Tolerance Limits for Central Nervous System

  • I. A. Sulg

Abstract

The term neuromonitoring refers to the semicontinuous recording, analysis, and display of some vital nervous system functions in high risk procedures in order to detect spontaneous or induced changes in a patient’s condition when special circumstances (such as anesthesia, neuromuscular blocking, artificial ventilation, induced drug coma, or primary coma of various origin) make neurological observation difficult. Neuromonitoring delivers information about the integrity or possible disturbances of certain nervous system functions [10, 76, 102]. Some alterations of monitored variables during surgical or other critical procedures from their preoperative characteristics can be interpreted as a warning, indicating that there may be a deficiency in tissue oxygenation [11, 14, 30, 152]. These neurofunctional warning signs usually precede irreversible changes as a result of definite structural damage. When these signs (such as EEG slowing or decrement in evoked response amplitudes) appear, there may still be time to prevent permanent damage. The following functions of the central nervous system can be monitored in quantified terms: EEG, evoked cerebral responses (EvCR), cerebral blood flow (CBF), cerebral oxygen consumption (CMRO2), and intracranial pressure (ICP).

Keywords

Ischemia Morphine Fentanyl Ketamine Isoflurane 

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© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • I. A. Sulg

There are no affiliations available

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