The surgical treatment of spinal arteriovenous malformations has been improved markedly during the last several years by use of the operating microscope and microsurgical instrumentations. The possibility of total removal has been viewed pessimistically. However, total extirpation of spinal intramedullary arteriovenous malformation(AVM) can be possible by use of intraoperative monitoring of the somatosensory evoked potentials(SEPs). Authors report a case of spinal intramedullary glomus AVM which was successfully removed with intraoperative monitoring of the SEPs and discuss surgical management. Intraoperative monitoring of the SEPs to determine the safety of removing of the spinal intramedullary AVM is stressed.
Arteriovenous Malformations ; Monitoring, Intraoperative*

At the present time, a kind of monitoring technology assuring highly effectual anesthesia is urgently required in the clinical practice. Electroencephalogram (EEG) assumes a dominant position in the current research of the depth detection of anesthesia. In this paper, the monitoring technique of the depth detection of anesthesia by bispectral index (BIS) is systematically showed. The bispectral index is a compound parameter which is composed of time domain, frequency domain, and high order spectral subparameters of the electroencephalograph. This nonlinear compound calculation method is worth research and is of great significance to the development of a new monitor of closed-loop control of anesthesia.
Anesthesia ; methods ; Electroencephalography ; methods ; Monitoring, Intraoperative ; methods

No abstract available.
Cerebellopontine Angle* ; Intraoperative Neurophysiological Monitoring* ; Neuroma, Acoustic*

BACKGROUND: Caudal epidural anesthesia is commonly performed in conjunction with general anesthesia. Bupivacaine and Levobupivacaine are used in epidural blockade that provide anesthesia and analgesia intraoperative and post-operatively.

OBJECTIVES: To compare the intraoperative and postoperative efficacy and safety of Bupivacaine and Levobupivacaine in children undergoing elective sub-umbilical operations under general and caudal anesthesia.

METHODS: Randomized control trial done in Philippine Children's Medical Center. Sixty-one subjects aged 6-months -8 years old, ASA I-II, undergoing subumbilical operations were randomly grouped to receive Bupivacaine and Levobupivacaine during anesthesia induction. Hemodynamic parameters, Bromage, and CHIPPS were recorded.

RESULTS: Results suggest both drugs have a significant effect in lowering heart rate and MAP. Bromage scores for patients from both groups are consistent at 0. The number of patients with a CHIPPS classification of 4-10, is significantly higher for bupivacaine group than levobupivacaine group.

CONCLUSION: Both Bupivacaine and Levobupivacaine provide adequate analgesia intraoperatively with no reports of intraoperative movement, increased inhalational agent concentration and additional intravenous analgesics. Post-operatively, no adverse effects and motor block was noted however Levobupivacaine has a longer efficacy as it required lesser rescue does post-operatively compared to Bupivacaine. 

According to the basic work principle of Datex Ohmeda 7100 anesthetic machine, the calculation formula of inspiratory tidal volume is deduced in the paper. The formula is verified by clinical application. The summary how to direct the applying and maintaining anesthetic machine and its monitoring instrument by using formula is presented.
Anesthesia ; methods ; Monitoring, Intraoperative ; instrumentation ; methods ; Surgical Equipment ; Tidal Volume

Humans ; Monitoring, Intraoperative ; methods ; trends ; Perioperative Care ; methods ; trends

From a view point of an anesthesiologist, the article points out some design issues of modern monitors and anesthesia machines. User interface problems such as auto-adjusted amplitude display, excessively complicated menus, unreasonable switch arrangement, unsuitable alarm settings or identical cylinder connectors, may affect patient safety and increase anesthesiologists' workload or mental burden.
Anesthesiology ; instrumentation ; Equipment Design ; Monitoring, Intraoperative ; instrumentation ; Safety

Humans ; Hyperparathyroidism, Secondary ; diagnosis ; Monitoring, Intraoperative ; Parathyroid Hormone ; blood ; Parathyroidectomy

BACKGROUND AND PURPOSE: We studied the clinical significance of amplitude-reduction and disappearance alarm criteria for transcranial electric muscle motor-evoked potentials (MEPs) during cervical spinal surgery according to different lesion locations [intramedullary (IM) vs. nonintramedullary (NIM)] by evaluating the long-term postoperative motor status. METHODS: In total, 723 patients were retrospectively dichotomized into the IM and NIM groups. Each limb was analyzed respectively. One hundred and sixteen limbs from 30 patients with IM tumors and 2,761 limbs from 693 patients without IM tumors were enrolled. Postoperative motor deficits were assessed up to 6 months after surgery. RESULTS: At the end of surgery, 61 limbs (2.2%) in the NIM group and 14 limbs (12.1%) in the IM group showed MEP amplitudes that had decreased to below 50% of baseline, with 13 of the NIM limbs (21.3%) and 2 of the IM limbs (14.3%) showing MEP disappearance. Thirteen NIM limbs (0.5%) and 5 IM limbs (4.3%) showed postoperative motor deficits. The criterion for disappearance showed a lower sensitivity for the immediate motor deficit than did the criterion for amplitude decrement in both the IM and NIM groups. However, the disappearance criterion showed the same sensitivity as the 70%-decrement criterion in IM (100%) and NIM (83%) surgeries for the motor deficit at 6 months after surgery. Moreover, it has the highest specificity for the motor deficits among diverse alarm criteria, from 24 hours to 6 months after surgery, in both the IM and NIM groups. CONCLUSIONS: The MEP disappearance alarm criterion had a high specificity in predicting the long-term prognosis after cervical spinal surgery. However, because it can have a low sensitivity in predicting an immediate postoperative deficit, combining different MEP alarm criteria according to the aim of specific instances of cervical spinal surgery is likely to be useful in practical intraoperative monitoring.
Extremities ; Humans ; Monitoring, Intraoperative ; Prognosis* ; Retrospective Studies ; Sensitivity and Specificity

We report that intraoperative NIM-2 monitoring devices can interfere with bispectral index monitoring. A 45-year-old male with chronic otits media underwent tympanolasty under general anesthesia with NIM-2 monitoring and bispectral index monitoring at our institution. And then, bispectral index monitoring was severely interrupted by facial nerve monitoring.
Anesthesia, General ; Consciousness Monitors ; Facial Nerve ; Humans ; Male ; Monitoring, Intraoperative