Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2023
ReviewAnesthesia management of neonates and infants requiring intraoperative neurophysiological monitoring: A concise review.
Intraoperative neurophysiological monitoring is currently used to prevent intraoperative spinal cord and nerve injuries during neonatal and infant surgeries. However, its use is associated with some issues in these young children. The developing nervous system of infants and neonates requires higher stimulation voltage than adults to ensure adequate signals, thereby necessitating reduced anesthesia dose to avoid suppressing motor and somatosensory-evoked potentials. ⋯ Furthermore, monitoring errors such as false-negative results immediately affect the prognosis of motor and bladder-rectal functions in patients. Therefore, anesthesiologists need to be familiar with the effects of anesthetics and age-specific neurophysiological monitoring challenges. This review provides an update regarding available anesthetic options and their target concentration in neonates and infants requiring intraoperative neurophysiological monitoring.