Implementation of intraoperative neurophysiologic monitoring in children and adults in secondary and tertiary health care facilities

Abstract

Introduction: Intraoperative neurophysiological monitoring (IONM) is a procedure that uses neurophysiological techniques in order to evaluate the motor and sensitive systems during surgeries that endanger the nervous system. Method: The approach, scope, target population, and clinical questions to be answered were defined. A systematic search of the evidence was conducted step by step; during the first stage, clinical practice guidelines were collected, during the second stage systematic reviews were obtained, and during the third stage, clinical trials and observational studies were procured. The MeSH nomenclature and free related terminology were used, with no language restrictions and a 5-10 years frame. The quality of the evidence was graded using the CEPD and SIGN scales. Results: Obtained using the search algorrhythms of 892 documents. Fifty-eight were chosen to be included in the qualitative synthesis. A meta-analysis was not possible due to the heterogeneity of the studies. Conclusions: Eighteen recommendations were issued and will support the adequate use of the IONM.

Lower extremity nerve injuries and their management at a referral center in Mexico City

“…All patients were operated on using intraoperative neurophysiological monitoring 17 . The most commonly used therapeutic measures were nerve transfers (7 cases, 33.3%) and application of nerve grafts for the management of gaps (7 cases, 33.3%).…”

Lesiones nerviosas en extremidad pélvica y su manejo en un centro de referencia en la Ciudad de México

“…Todos los pacientes fueron operados empleando monitoreo neurofisiológico transoperatorio 17 . Las medidas de tratamiento más empleadas fueron las transferencias nerviosas (7 casos, 33.3%) y la aplicación de injertos nerviosos para el manejo de brechas (7 casos, 33.3%).…”