In deel 1 (Critical Care nr. 4) van dit artikel zijn het doel, de indicatie en de methode van intraoperatieve neuromonitoring (IONM) met transcraniële elektrische stimulatie van motorische evoked potentials (TES MEP) beschreven. In dit tweede deel gaan we in op de vroegere methode, de benodigde anesthesietechniek en hoe te handelen bij aanwijzingen voor myelumschade zoals gemeten met TES MEP-monitoring.
Literatuur
Behandelrichtlijn scoliose bij neuromusculaire aandoeningen. 2007. Kwaliteitsinstituut voor de gezondheidszorg CBO, Utrecht.
Calenbergh F van. Editorial Intraoperatieve neuromonitoring. Tijdschr Neurol Neurochir 2010;111 nr 5:188–9.
Dongen EP van, Beek HT ter, Aarts LP, Schepens MA, Morshuis WJ, Benning FJ, De Boer A, Boezeman EH. The effect of two low-dose propofol infusions on the relationship between six-pulse transcranial electrical stimulation and the evoked lower extremity muscle response. Acta Anaesthesiol Scand 2000; 44: 799–803.
Hal C van, Hoebink E, Polak HE, Racz I, Kleuver M de, Journée HL. Optimum Interpulse Interval Times in TES elicited MEP Amplitudes for the Upper and Lower extremity Muscle Groups. Lezing op het Symposium Intraoperative Neurophysiologic Monitoring, 2010 Groningen.
Hoebink EA, van Hal C, Kleuver M de, Racz I, Polak HE, Journée HL. Reducing risk of bite injuries in transcranial electrical stimulation (TES) by optimizing stimulation parameters. Lezing op het Symposium Intraoperative Neurophysiologic Monitoring, 2010 Groningen.
Jacobs MJ, Elenbaas TW, Schurink GWH, Mess WH, Mochtar B. Assessment of Spinal Cord Integrity During Thoracoabdominal Aortic Aneurysm Repair. Ann Thorac Surg 2002;74:S1864–6.
Jacobs J, Janssen H, Hosman AJF, Bartels RHMA, Alfen N van. Scoliose en interoperatieve neuromonitoring. Tijdschr Neurol Neurochir 2010;111 nr 5: 190–9.
Journée HL, Polak HE, Kleuver M de, Langeloo DD, Postma AA. Improved neuromonitoring during spinal surgery using double-train transcranial electrical stimulation. Medical & Biological Engineering & Computing, 2004, 1: 110–113.
Journée HL, Polak HE, Kleuver M de. Influence of electrode impedance on threshold voltage for transcranial electrical stimulation in motor evoked potential monitoring. Med.Biol.Eng Comput., 2004, 42(4):557–61.
Journée HL, Polak HE, Kleuver M de. Conditioning stimulation techniques for enhancement of transcranially elicited evoked motor responses. Neurophysiol Clin. 2007 Dec;37(6):423–30.
Langeloo DD, Journée HL, Polak B, Kleuver M de. A new application of TcE MEP: spinal cord monitoring in patients with severe neuromuscular weakness undergoing corrective spine surgery. J.Spinal Disord., 2001, 14, no. 5: 445–448.
Langeloo DD, Lelivelt A, Journée HL, Slappendel R, Kleuver M de. Transcranial electrical motor-evoked potential monitoring during surgery for spinal deformity - A study of 145 patients, Spine 28, 2003; 1043–1050.
Langeloo DD, Journée HL, Pavlov PW, Kleuver M de. Cervical osteotomy in ankylosing spondylitis: evaluation of new developments, Eur.Spine J. 15, 2006; 493–500.
Langeloo DD, Journée HL, Kleuver M de, Grotenhuis JA. Criteria for transcranial electrical motor evoked potential monitoring during spinal deformity surgery A review and discussion of the literature. Neurophysiol Clin. 2007 Dec;37(6):431–9.
Langeloo DD. Monitoring of the spinal cord during corrective spinal surgery. A clinical study of TES-MEP. Proefschrift. 2007. Nijmegen.
Polak HE, Racz I, Journée HL, Kleuver M de. Interoperatieve neuromonitoring. NTvAn med. 2009 vol 26; nr5 sep 7–11.
Scoliosis Research Society: SRS Information Statement, January 2009.
Ubags LH, Kalkman CJ, Been HD, et al. The use of a circumferential cathode improves amplitude of intraoperative electrical transcranial myogenic motor evoked responses. Anesth Analg 1996; 82:1011–4.
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anesthesie- en neuromonitoringassistent
neurofysioloog
directeur orthopediecentrum, orthopedisch chirurg
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Polak, H.E., Journée, H.L. & de Kleuver, M. Intraoperatieve neuromonitoring bij operatie aan de wervelkolom (2). CRITIC. CARE 9, 18–21 (2012). https://doi.org/10.1007/s12426-012-0095-3
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DOI: https://doi.org/10.1007/s12426-012-0095-3