A vision of the future of intraoperative monitoring for anesthesia is presented-a multimodal world based on advanced sensing capabilities. I explore progress towards this vision, outlining the general nature of the anesthetist's monitoring task and the dangers of attentional capture. Research in attention indicates different kinds of attentional control, such as endogenous and exogenous orienti...

Anesthesiologists are the primary users of preoperative medical consultations (consults), but the information in consults is often of limited usefulness to anesthesiologists and the rest of the surgical and perioperative team. The purpose of a consult is not to "clear" a patient for surgery but rather to optimize a patient's underlying disease states before they are compounded by the insult of ...

introduction: we present a retrospective two-center study series and discussion of the current literature to assess the benefits of facial nerve monitoring during parotidectomy. materials and methods: from 2007 to 2012, 128 parotidectomies were performed in 125 patients. of these, 47 procedures were performed without facial nerve monitoring (group 1) and 81 with facial nerve monitoring (group 2...

Background: Intraoperative awareness is a rare but extremely unfavourable phenomenon affecting 0.1–0.2% of patients who undergo surgery under general anaesthesia. The event exposes patients to stress and its remote, severe outcomes. The aim of the present study was to determine the incidence of intraoperative awareness in patients undergoing general anaesthesia. Methods: The observational quest...

background : subthalamic nucleus (stn) stimulation is the  reatment of choice for carefully chosen patients with idiopathic parkinson's disease (pd) and refractory motor fluctuations. we evaluated the value of intraoperative electrophysiology during stn deep brain stimulation (dbs) procedures in refining the anatomically-defined target. methods : we determined the spatial distance between the a...

As early as 1997 the first clinical publications showed the clinical benefits of using intra-operative Magnetic Resonance Imaging: “Intra-operative MRI can be expected to increase the degree and accuracy of resection” . Other studies have looked at post-operative MRI imaging and indicate that intra-operative MRI would have had an influence on the clinical outcome . All recent studies concur tha...

I t has long been appreciated that a patient’s physiological status is dynamic and subject to rapid, life-threatening changes during surgery Anesthesiologists routinely use extensive physiological monitoring to maintain the patient’s homeostasis. This monitoring can be thought of as establishing a control loop between the anesthesiologist and patient for the purposes of life support. Some infor...

Intraoperative neurophysiological monitoring (IONM) makes it possible to determine the status of neurological function during surgery. It guides the surgeon and minimises the risk of injury. This paper describes the different techniques available for IONM in spine surgery (somatosensory evoked potentials, motor evoked potentials, neurography, electromyography, reflexes and dermatomic evoked pot...

The risk for complications while providing any level of sedation or general anesthesia is greatest when caring for patients having significant medical compromise. It is reassuring that significant untoward events can generally be prevented by careful preoperative assessment, along with attentive intraoperative monitoring and support. Nevertheless, we must be prepared to manage untoward events s...