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Evoked potentials in surgical neuromonitoring and effects of anesthesia
This is a slide on evoked potentials used as neuromonitoring in surgery as well as the effects of anesthesia on the evoked potentials.
ADDITIONAL TAGS:
Evoked potentials
Stimulus
Pathways monitored
Relevant surgeries
Effect of inhaled anesthetics
Brainstem auditory evoked potentials (BAEP)
Acoustic → BAEP electrode placed on scalp
Cochlea → cochlear nerve, through the cochlear nucleus (CN VIII) → superior olivary complex → lateral lemniscus → inferior colliculus in the midbrain → medial geniculate body → auditory cortex
Posterior fossa surgeries
Minimal
Motor evoked potentials (MEP)
Magnetic stimulation or transcranial electrical stimulation of the motor cortex → MEP recorded from muscles
Motor cortex
Brainstem
Descending motor pathways
Peripheral nerve
Spine
↓ amplitude and ↑ latency
Total intravenous anesthesia is preferred but can use up to 0.5 MAC
Somato- sensory evoked potentials (SSEP)
An electrical stimulus is applied to the peripheral nerve → SSEP recorded from brain or spinal cord
Upper extremity: median or ulnar nerve
Lower extremity: posterior tibial nerve
Peripheral nerve
Dorsal root ganglion
Posterior column of the spinal cord
Cardio- vascular;
Endo- vascular;
Intra- cranial;
Spine
↓ amplitude and ↑ latency
Can use MAC of 0.5-1.0 during measurements
Visual evoked potentials (VEP)
Light flash or pattern stimulus → VEP electrode on visual cortex
Retina, optic nerve (CN II), optic chiasm, optic radiations, and occipital cortex
Ophthal-mic
↓ amplitude and ↑ latency
Agent
SSEP amplitude
MEP amplitude
Comments
Isoflurane; Sevoflurane; Desflurane


SSEP usually recorded at less than 1 MAC, MEP less than 0.5 MAC
N2O


Similar to isoflurane, synergistic when combined with halogenated agents
Propofol


SSEP and MEP usually recorded at anesthetic doses but MEP may be lost at high doses
Barbiturates


Similar to propofol; limited experience with MEP
Opioids
Minimal
Minimal
SSEP and MEP usually recorded even at high doses
Etomidate
↑ at low doses - ↓ at higher doses
↑ at low doses - ↓ at higher doses
Enhancement of SSEP and MEP seen at low doses, depression at very high doses
Ketamine
Minimal, ↑ at low doses
Minimal, ↑ at low doses
Enhancement SSEP and MEP seen at low doses
Benzo- diazepines
Minimal at low doses
Minimal at low doses, prolonged ↓ at higher doses
SSEP and MEP usually recorded with small doses for amnesia
Dexmede- tomidine
Minimal
Minimal - ↓ at higher doses
SSEP and MEP usually recorded at low doses but MEP lost at higher doses
Lidocaine
Minimal
Minimal
Can be used as intravenous supplement in SSEP and MEP
Anesthesia has greatest effects on MEP and SSEP
Inhalational agents have greater effects on neuromonitoring than IV drugs
Переглядів: 271

Відео

Neuromuscular blockers in myasthenia gravis and Lambert-Eaton
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Neuromuscular blockers in myasthenia gravis and Lambert-Eaton
Evaluation of transfusion reactions
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Evaluation of transfusion reactions
Intra-aortic balloon pump
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Intra-aortic balloon pump
Neuraxial procedures and anticoagulation
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MRI safety of devices and implants
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Thromboelastography
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Thromboelastography
Glucose transporters
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Glucose transporters
Retrobulbar and peribulbar blocks
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Retrobulbar and peribulbar blocks
Dominant EEG waveforms associated with common anesthetic agents
Переглядів 1785 місяців тому
Dominant EEG waveforms associated with common anesthetic agents
Brachial plexus and ultrasonic planes for nerve block
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Brachial plexus and ultrasonic planes for nerve block
Adrenergic receptors and actions
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Adrenergic receptors and actions
Thyroid-related laboratory abnormalities
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Thyroid-related laboratory abnormalities
Circulatory receptors and reflexes
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Circulatory receptors and reflexes
Medical conditions that dysregulate acetylcholine receptors
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Medical conditions that dysregulate acetylcholine receptors
Pontine syndromes caused by ischemic infarcts
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Pontine syndromes caused by ischemic infarcts
Lung cancer (mechanism of disease)
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Diabetic foot (mechanism of disease)
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Diabetic foot (mechanism of disease)
Primary amenorrhea (mechanism of disease)
Переглядів 6 тис.Рік тому
Primary amenorrhea (mechanism of disease)
Intracerebral hemorrhage (mechanism of disease)
Переглядів 2,5 тис.Рік тому
Intracerebral hemorrhage (mechanism of disease)
Subarachnoid hemorrhage (mechanism of disease)
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Subarachnoid hemorrhage (mechanism of disease)
Penetrating neck trauma (mechanism of disease)
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Penetrating neck trauma (mechanism of disease)
Ischemic stroke (mechanism of disease)
Переглядів 1,2 тис.Рік тому
Ischemic stroke (mechanism of disease)
Penetrating abdominal trauma (mechanism of disease)
Переглядів 2,8 тис.Рік тому
Penetrating abdominal trauma (mechanism of disease)
Penetrating chest trauma (mechanism of disease)
Переглядів 2,1 тис.Рік тому
Penetrating chest trauma (mechanism of disease)
Type IV hypersensitivity (mechanism of disease)
Переглядів 454Рік тому
Type IV hypersensitivity (mechanism of disease)
Schistosomiasis (mechanism of disease)
Переглядів 3,8 тис.Рік тому
Schistosomiasis (mechanism of disease)
Endemic fungal infections: Histoplasmosis, (Para)Coccidioidomycosis, Blasto (mechanism of disease)
Переглядів 1,4 тис.Рік тому
Endemic fungal infections: Histoplasmosis, (Para)Coccidioidomycosis, Blasto (mechanism of disease)
Type III hypersensitivity (mechanism of disease) with examples
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Serotonin syndrome (mechanism of disease)
Переглядів 2,2 тис.Рік тому
Serotonin syndrome (mechanism of disease)

КОМЕНТАРІ

  • @TheWhateverMan420
    @TheWhateverMan420 18 годин тому

    Just took my test today. Thank you for this information!

  • @seadimogladness2461
    @seadimogladness2461 День тому

    You really helped me. Thank you

  • @Mevvviii
    @Mevvviii 2 дні тому

    Oh god i just found out about this im scared how common is it😭?

  • @ahmedfalah8611
    @ahmedfalah8611 2 дні тому

  • @kapswishes9834
    @kapswishes9834 2 дні тому

    Cherry pit contains cynaide So cherry red skin ❤❤❤

  • @SuhimInyana
    @SuhimInyana 2 дні тому

    Can u share the flow chart? The link maybe or else

  • @SuhimInyana
    @SuhimInyana 2 дні тому

    Can u share the flow chart? The link maybe or else

  • @SuhimInyana
    @SuhimInyana 2 дні тому

    Can u share the flow chart? The link maybe or else

  • @PearlDoko
    @PearlDoko 3 дні тому

    Thank you so much

  • @Charlott172
    @Charlott172 3 дні тому

    I’m excited I’m cured from herpes thanks too #DrOseghaleSundayHerbalHome 🏡

  • @user-xo5cs8sd6g
    @user-xo5cs8sd6g 4 дні тому

    Great❤

  • @kaitlynadams9816
    @kaitlynadams9816 5 днів тому

    Can you fix it

  • @jaydeedubya
    @jaydeedubya 5 днів тому

    Why are you speaking so fast??

  • @robbyakbarsyah7719
    @robbyakbarsyah7719 5 днів тому

    I HAVE A PRESENTATION TOMORROW AND THANK GOD I FOUND YOUR VIDEO.......THIS IS THE MOST BRILLIANT CHART FOR LEARNING THYROTOXICOSIS OUT THERE

  • @lucyalvarez1288
    @lucyalvarez1288 7 днів тому

    Thank you for this perfect video🙏🏼

  • @indicablue7450
    @indicablue7450 7 днів тому

    My ex fiancee Died from This and he at the time of his death threw up well so much orange fluids clear orange fluid just pulled and pulled and pulled and pulled pout of his mouth and nose and I had to use pillows to soak This up to resuscitate him which was unsuccessful I really like some answers

  • @deependrasinghrajput2473
    @deependrasinghrajput2473 7 днів тому

    Can ocd be completely cured?

  • @farazanjum7844
    @farazanjum7844 7 днів тому

    Very nice.very neatly explained.

  • @MohanKumar-ul7yi
    @MohanKumar-ul7yi 7 днів тому

    this video is very awesome....,this channel is very underrated..keep going man❤

  • @mikebelz5755
    @mikebelz5755 7 днів тому

    Great summary! thank you ❤

  • @AdrianRodriguez-km2jf
    @AdrianRodriguez-km2jf 9 днів тому

    The human papillomavirus infects immature squamous cells and viral replication takes place there, the cervix has this metaplastic epithelium vulnerable to HPV, the pathogenesis is characterized why does the virus produce proteins such as E7 that binds to RB and E6 that inhibits P53, useful molecules to arrest the cell cycle but the virus takes them to a state of proliferation and causes lesions called cervical intraepithelial neoplasias that can be low grade or high grade that can cause cervical carcinoma

  • @JGarriso
    @JGarriso 9 днів тому

    So this is why I have GERD now after my surgery a month ago 😢 seeing ENT and gastrointestinal doc now it’s horrific

  • @lucar1613
    @lucar1613 10 днів тому

    Not true it is not irreeversable simple google search and pub med papers talk about this and methionine cycle resumes after about 4 days

  • @amyna9675
    @amyna9675 10 днів тому

    what is ulcerative dyspepsia

  • @amyjenkins9187
    @amyjenkins9187 11 днів тому

    My blood work showed I had tear drop & oval shaped cells, what can that mean?

  • @shihtzu1066
    @shihtzu1066 11 днів тому

    Erythema migrain

  • @AnaMartinez-ed1uw
    @AnaMartinez-ed1uw 11 днів тому

    what if my MRI showed empty sella and intracranial hypertension ? should i still get a spinal tap i suffer from tinnitus and neck pain :/

  • @benitoquiroz6358
    @benitoquiroz6358 11 днів тому

    So useful! Thank you sir 💪

  • @leifotto4277
    @leifotto4277 11 днів тому

    You forgot “causes dementia in elderly patients, with clear mental impairment becoming noticeable within 6-12 months post-exposure, and severe debility within 3-5 years.”

  • @nenyechinenye4724
    @nenyechinenye4724 11 днів тому

    Best video

  • @dakota780
    @dakota780 12 днів тому

    was this supposed to be super sped up?

  • @dakota780
    @dakota780 12 днів тому

    was this supposed to be super sped up?

  • @luzrodriguez1214
    @luzrodriguez1214 12 днів тому

    Thanks 😮

  • @bibidramas
    @bibidramas 13 днів тому

    will tracheostomy reduces dependency on ventilator?

  • @MsAMAZINGMOM
    @MsAMAZINGMOM 13 днів тому

    Thanks, a nice quick comprehensive breakdown of polyneuropathy. I "might" have Axonal neuropathy, as CIDP has apparantly been ruled out, so now testing for Axonal. Runner's dystonia was also a possible diagnosis but none of the treatments helped, just horrible side-effects.

  • @mutalashahida956
    @mutalashahida956 14 днів тому

    My 8 years old girl suffering from bladder disfunction what is the treatment please suggest

  • @muratkaanyildiz4264
    @muratkaanyildiz4264 14 днів тому

    I have always believe they have a cure and that there is too much money to be made so they don't give it to people hopefully I am proved wrong some day

  • @rachnayadav3897
    @rachnayadav3897 15 днів тому

    Thank you

  • @firstjedi2
    @firstjedi2 15 днів тому

    The whole video is made in alien language

  • @Hartleymolly
    @Hartleymolly 15 днів тому

    My blood pressure was low….

  • @JamiePelagio
    @JamiePelagio 16 днів тому

    I was diagnosed with adenomyosis last month... Im just 22 and no kids yet... Maybe i will never be a mother which is heartbreaking 💔

  • @beatbosshqtm3866
    @beatbosshqtm3866 16 днів тому

    Shir-mer test not schry-mer test

  • @beatbosshqtm3866
    @beatbosshqtm3866 16 днів тому

    Sho-grens not Shro-gen

  • @kennethmutumaihuthia1155
    @kennethmutumaihuthia1155 16 днів тому

    How can someone download this shorts?

  • @trishaadona5626
    @trishaadona5626 16 днів тому

    What is adnexal mass means

  • @dq1555
    @dq1555 16 днів тому

    Amazing is there another video on nephrotic syndrome?

  • @Brahmanrbg
    @Brahmanrbg 17 днів тому

    I enjoy watching your videos

  • @Sukariguru374
    @Sukariguru374 17 днів тому

    Thank you. I was diagnosed with osteoporosis last year, and this year, I was diagnosed with hyperthyroidism. There's not much I can do about any of it other than change my diet to low iodine food. Which means not eating very much, and many of the foods I ate for osteoporosis I can not eat with hyperthyroidism. My life is in God's hands.

  • @Botoshel19
    @Botoshel19 18 днів тому

    What a bunch of crap. Made by a group of people so that they’re always in advantage compared to the poor unfortunate soul that’s trapped in their “sick test”. How can people tolerate such insanity? One man judging another because he feels he has the right to do so? Man these people have never had their teeth knocked out while they were teens for sure otherwise they’d know what truly dangerous consequences for one’s behaviour meant.

  • @Ani66501
    @Ani66501 18 днів тому

    The nightmares are brutal! Better than waking up on my kitchen floor covered in piss and puke with no recollection of getting there though..