Departments of Neurology and Clinical Neurophysiology, David Geffen School of Medicine, University of California Los Angeles, and Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States.
Department of Neurology, Duke University Medical Center and Neurodiagnostic Center, Veterans Affairs Medical Center, Durham, NC, United States.
Handb Clin Neurol. 2022;186:3-9. doi: 10.1016/B978-0-12-819826-1.00011-9.
Intraoperative neuromonitoring (IONM) is used widely to reduce neurologic adverse postoperative outcomes. A variety of techniques are used. Initial techniques were used as far back as the 1930s, and the variety of methods expanded greatly since the 1980s. Many methods monitor baseline findings over time. Other methods test for neurologic function to identify nerves or eloquent cortex. Physicians trained in neurophysiology are key for interpretation of findings, supervision of staff, and making medical recommendations to the surgeon or anesthesiologist. Some neurophysiologists provide the services personally, and in other circumstances well-trained technologist staff help with the techniques. Much IONM is provided by the neurophysiology physician in the operating room, whereas in other cases, the physician may be on-line in real time from a remote site. When monitoring identifies changes, the IONM team must give a clear, timely, and compelling message to the surgeon and anesthesiologist.
术中神经监测（IONM）被广泛用于降低神经术后不良结局。有多种技术被应用。最早的技术可以追溯到 20 世纪 30 年代，自 20 世纪 80 年代以来，方法的种类大大增加。许多方法监测随时间的基线发现。其他方法则测试神经功能以识别神经或言语中枢。接受神经生理学培训的医生是解读发现、监督工作人员以及向外科医生或麻醉师提供医疗建议的关键。一些神经生理学家亲自提供服务，在其他情况下，训练有素的技术人员会协助完成技术。许多 IONM 是由手术室中的神经生理学医生提供的，而在其他情况下，医生可能会从远程站点实时在线。当监测识别出变化时，IONM 团队必须向外科医生和麻醉师清晰、及时、有力地传达信息。
