Goonasekera Chulananda, Jones Holly, Lawrence Rebekah, Hanrahan John, Iyer Priyanka, Nijhawan Aditi
Department of Anesthetics, King's College Hospital NHS Trust, Denmark Hill, London SE59RS, UK.
King's College London Faculty of Life Sciences and Medicine, School of Medicine, London, UK.
Saudi J Anaesth. 2021 Jan-Mar;15(1):7-13. doi: 10.4103/sja.SJA_862_20. Epub 2021 Jan 5.
The purpose of intraoperative neuro-monitoring (IONM) is to minimize injury to eloquent neural structures and optimize tumor resection.
We explored the utility of IONM using a qualitative approach in a single center. Eight experienced users of its use in spinal and cranial surgery in adults and children were the informants. Using a constant comparative method, the findings were collated by thematic analysis.
The user perspective is that of caution to minimize adverse effects whilst empowering the need for formal training to enhance its efficacy. The process of IONM needs standardization as practices vary amongst users. Most users expressed limited trust on its current capabilities but hoped for its advancement to achieve higher sensitivity and specificity. None were however prepared to abandon its use.
IONM needs optimization. Its utility depends on user vigilance, multi-disciplinary validation, and individual expertise. This study draws out key issues from the user perspective that need to be addressed in order to enhance the utility of IONM.
术中神经监测（IONM）的目的是将对明确神经结构的损伤降至最低，并优化肿瘤切除。
我们在单一中心采用定性方法探索了IONM的效用。八位在成人和儿童脊柱及颅脑手术中使用IONM的经验丰富的使用者作为 informant。采用持续比较法，通过主题分析对结果进行整理。
使用者的观点是谨慎行事以尽量减少不良影响，同时强调需要进行正规培训以提高其功效。IONM 的过程需要标准化，因为使用者之间的操作存在差异。大多数使用者对其当前能力表示有限的信任，但希望其取得进展以实现更高的灵敏度和特异性。然而，没有人准备放弃使用它。
IONM 需要优化。其效用取决于使用者的警惕性、多学科验证和个人专业知识。本研究从使用者角度提出了一些关键问题，为提高IONM 的效用，这些问题需要得到解决。
