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Review
. 2019 May;19(5):165-171.
doi: 10.1016/j.bjae.2019.01.007. Epub 2019 Mar 8.

Intraoperative neuromonitoring in paediatric spinal surgery

D N Levin  1   2 , S Strantzas  1 , B E Steinberg  1
Affiliations
Review

Intraoperative neuromonitoring in paediatric spinal surgery

D N Levin et al. BJA Educ. 2019 May.
No abstract available

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Checklist for responding to intraoperative neuromonitoring changes in patients undergoing spinal surgery (adapted from Vitale and colleagues and Ziewacz and colleagues).,
Fig. 2
Fig. 2
EEG signals change with varying propofol infusion rates. EEG signal is shown in both the time (left) and frequency (right) domains at differing propofol infusion rates running in conjunction with a remifentanil infusion at 0.1 μg kg−1 min−1. The EEG waves are classified by frequency from high (8–15 Hz α-activity and 15–25 Hz β-activity) to low (1–3 Hz δ-activity and 4–7 Hz θ-activity). Greater DOA is associated with a prominence of low-frequency components as demonstrated in the top recordings at propofol 150 μg kg−1 min−1 with low-frequency large-amplitude waves. In this case, the majority of the frequency power is in the δ and θ range. As the propofol infusion rate is decreased, there is a corresponding decrease in amplitude of the raw EEG and a shift towards higher-frequency activity (middle and bottom), indicative of lightening of anaesthesia. EEG recording: Cp3-Fpz (red trace), Cp4-Fpz (blue trace), and Cz-Fpz (black trace), and the filter settings are 0.5 Hz low-frequency filter (LFF) and 35 Hz high-frequency filter (HFF).
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