|Title||Neuromonitoring in the ambulatory anesthesia setting: a pro-con discussion.|
|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||Grosland JO, Todd MM, Goldstein PA|
|Journal||Curr Opin Anaesthesiol|
|Date Published||2018 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 Journal||Curr Opin Anaesthesiol|