Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2007
Comparative StudyComparing eye movements recorded by search coil and infrared eye tracking.
The performance of a new video-based infrared eye tracker (IR) was compared to the magnetic search coil technique (SC). Since the IR offers interesting possibilities as a diagnostic tool in neuro-ophthalmology, it was investigated whether the new device has overcome shortcomings that were reported from former IR systems. ⋯ The results show that the IR and the SC were in good agreement and produced similar results. In contrast to other studies, the influence of the sampling rate of the IR was small. The saccade main-sequences did not show significant differences. The latency times observed for both systems were mainly in the short-latency range.
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J Clin Monit Comput · Feb 2007
Generalized peripheral nerve failure during thoracic spine surgery: a case report.
Intra-operative systemic changes impairing peripheral nerve function are not commonly detected with electrophysiology. This case presentation illustrates how somatosensory evoked potential (SSEP) monitoring can detect global changes in peripheral nerve excitability during spine surgery. ⋯ Somatosensory evoked potential monitoring during spine surgery can detect uncommon generalized nerve conduction block, and further alert surgical teams to a systemic impairment. This was discovered to result from a compromised endotracheal tube. This can apply in various monitoring situations, as the changes affecting the SSEPs were not related to surgical manipulation.
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J Clin Monit Comput · Feb 2007
Enhancement of the bulbocavernosus reflex during intraoperative neurophysiological monitoring through the use of double train stimulation: a pilot study.
Electrophysiological bulbocavernosus reflex (BCR) testing, during surgeries in which the constituent neural components are at risk, might supplement other low sacral (S2-4) stimulation/recording techniques. However, intraoperative BCR is not always reliably implemented. We proposed to analyze BCR signals in five surgical patients monitored with the novel application of double train stimulation (DTS) to determine if the potential could be enhanced. ⋯ Intraoperative BCR is currently obtained with some difficulty using pulse train stimulation. Our preliminary evidence has identified BCR waveform enhancement using DTS and suggests that the reliability of intraoperative BCR acquisition may be further improved by the addition of this technique. Our data are insufficient to define the best intertrain interval.
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The use of processed electroencephalography (EEG) using a simple frontal lead system has been made available for assessing the impact of anesthetic medications during surgery. This review discusses the basic principles behind these devices. The foundations of anesthesia monitoring rest on the observations of Guedel with ether that the depth of anesthesia relates to the cortical, brainstem and spinal effects of the anesthetic agents. ⋯ Using mathematical processing techniques, commercial EEG devices create an index usually between 0 and 100 to characterize this drug effect. Critical aspects of memory formation occur in the frontal lobes making EEG monitoring in this area a possible method to assess risk of recall. Integration of processed EEG monitoring into anesthetic management is evolving and its ability to characterize all of the anesthetic effects on the CNS (in particular awareness and recall) and improve decision making is under study.
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J Clin Monit Comput · Dec 2006
The influence of sevoflurane on the bispectral index, regional cerebral oxygen saturation, and propofol concentration during propofol/N2O anesthesia.
This study was undertaken to investigate the influence of sevoflurane on the bispectral index (BIS), regional cerebral oxygen saturation (rSO(2)), and serum propofol concentration during propofol/N(2)O anesthesia. This study tested the hypothesis that sevoflurane affect BIS values, rSO(2), and the pharmacokinetics of propofol during propofol/ N(2)O anesthesia. ⋯ We have shown that sevoflurane decreases BIS values during propofol/N(2)O anesthesia without affecting rSO(2) and that this change is accompanied by an increase in serum propofol concentration. Changes in propofol concentration may be due to, at least in part, hemodynamic changes such as decreased CO produced by sevoflurane.