Neuromonitoring in the ambulatory anesthesia setting: a pro-con discussion.

TitleNeuromonitoring in the ambulatory anesthesia setting: a pro-con discussion.
Publication TypeJournal Article
Year of Publication2018
AuthorsGrosland JO, Todd MM, Goldstein PA
JournalCurr Opin Anaesthesiol
Date Published2018 Aug 18

PURPOSE OF REVIEW: Various neurologically focused monitoring modalities such as processed electroencephalography (pEEG), tissue/brain oxygenation monitors (SbO2), and even somatosensory evoked responses have been suggested as having the potential to improve the well tolerated and effective delivery of care in the setting of outpatient surgery. The present article will discuss the pros and cons of such monitors in this environment.

RECENT FINDINGS: There is a paucity of evidence from rigorous, well designed clinical trials demonstrating that the routine use of any neuromonitoring technique in an ambulatory surgery setting leads to meaningful cost savings or a reduction in morbidity or mortality.

SUMMARY: The use of advanced neuromonitoring techniques (primarily pEEG) may be considered reasonable in two instances: for the prevention of intraoperative awareness during the administration of total intravenous anesthesia coupled with the use of a neuromuscular blocking drug, and for the prevention of relative drug overdose (and possibly postoperative delirium) in the elderly.

Alternate JournalCurr Opin Anaesthesiol
PubMed ID30124541