Intraoperative Neuromonitoring: Principles and Considerations for Perioperative Nurses

Intraoperative neuromonitoring (IONM) is a method used to warn the surgeon of impending neurological damage while it can still be corrected, ideally preventing a permanent neurological deficit in the surgical patient. It was originally used in neurosurgery, but now also applies to other surgical specialties. Comprehensive monitoring of a patient's neurological status requires using a variety of approaches. The IONM tests most frequently used in the OR are somatosensory evoked potentials; transcranial electrical motor evoked potentials; electromyography, including cranial nerve monitoring; and electroencephalography. With its increased use during a variety of operative and other invasive procedures, most perioperative nurses will be exposed to IONM at some point in their careers. This article provides perioperative nurses with a basic understanding of IONM, including the framework, purpose, associated terminology, and nursing implications.