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Hyper Smash

Thursday, June 24, 2010

Antoun Koht, M.D.

Anesthesiologists should re-evaluate and re-ignite their interest in neurophysiologic monitoring.
Their active involvement could lead to improved neuromonitoring today and allow
for possible supervision in the future.

Currently, neurophysiologic monitoring is conducted by trained technologists capable of
operating the neuromonitoring machine, connecting wires, obtaining reproducible signals,
and identifying signal changes; and they should be able to troubleshoot technical issues contributing to signal changes. However, diagnosis of the etiology of signal changes may be difficult
and outside the realm of their expertise. In order to elucidate signal change etiology, it is necessary to examine all potential causative factors, including rapidly checking monitoring circuit integrity, evaluating patient position, optimizing physiologic status, eliminating pharmacologic contributions, and correlating surgical maneuvers with signal changes.