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Intraoperative neurophysiological monitoring in paediatric neurosurgery
Prasanna U Bidkar1, Astha Thakkar2, Nitin Manohar3
1Division of Neuroanaesthesia, Department of Anaesthesiology and Critical care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Insights
Intraoperative neurophysiological monitoring (IONM) is increasingly used in pediatric surgery. This review covers IONM
Area of Science:
- Neurosurgery
- Pediatric Medicine
- Neurophysiology
Background:
- Intraoperative neurophysiological monitoring (IONM) is standard in adult surgery.
- Technological and anesthetic advancements have expanded IONM use to pediatric patients.
- Pediatric IONM presents unique challenges due to anatomical and physiological differences.
Purpose of the Study:
- To review the application of IONM in pediatric neurosurgery.
- To discuss patient characteristics, surgical types, and technical/anesthetic considerations for pediatric IONM.
Main Methods:
- Literature review of IONM in pediatric spinal and cranial neurosurgical procedures.
Main Results:
- IONM aids in localizing neural structures during pediatric surgeries.
- Preservation of neural structures through IONM can decrease postoperative neurological deficits.
- IONM contributes to better patient outcomes in pediatric neurosurgery.
Conclusions:
- IONM is a valuable tool in pediatric neurosurgery, despite unique challenges.
- Careful consideration of patient-specific factors and anesthetic management is crucial for successful pediatric IONM.
Abstract:
Intraoperative neurophysiological monitoring (IONM) is commonly used in various surgical procedures in adults, but with technological and anaesthetic advancements, its use has extended to the paediatric population. The use of IONM in children poses a unique set of challenges considering the anatomical and physiological differences in this group of patients. The use of IONM aids in the localization of neural structures and enables surgeons to preserve the functional neural structures leading to decreased incidence of postoperative neurological deficits and better patient outcomes. In this article, we review the use of IONM in paediatric patients undergoing various spinal and cranial neurosurgical procedures. We discuss the patient characteristics, type of surgeries, and technical and anaesthetic considerations about IONM in this population.
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