Share
array:22 [ "pii" => "S234119292100024X" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.02.002" "estado" => "S300" "fechaPublicacion" => "2021-02-01" "aid" => "1257" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2021;68:53-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S003493562030298X" "issn" => "00349356" "doi" => "10.1016/j.redar.2020.12.001" "estado" => "S300" "fechaPublicacion" => "2021-02-01" "aid" => "1257" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Esp Anestesiol Reanim. 2021;68:53-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">EDITORIAL</span>" "titulo" => "Monitorización neurofisiológica intraoperatoria, medicina personalizada y trabajo en equipo" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "55" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Intraoperative neurophysiological monitoring, personalized medicine and teamwork" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "N. Fàbregas Julià" "autores" => array:1 [ 0 => array:2 [ "nombre" => "N." "apellidos" => "Fàbregas Julià" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S234119292100024X" "doi" => "10.1016/j.redare.2021.02.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234119292100024X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493562030298X?idApp=UINPBA00004N" "url" => "/00349356/0000006800000002/v2_202102140648/S003493562030298X/v2_202102140648/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192921000214" "issn" => "23411929" "doi" => "10.1016/j.redare.2020.11.001" "estado" => "S300" "fechaPublicacion" => "2021-02-01" "aid" => "1246" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2021;68:56-61" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial Article</span>" "titulo" => "Measures for prevention of infection transmission in the operating room: Paradigm shift after COVID-19" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "56" "paginaFinal" => "61" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Medidas de control de la transmisión de infecciones en el entorno quirúrgico: cambio de paradigma tras la COVID-19" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2242 "Ancho" => 3167 "Tamanyo" => 702014 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Diagram summarizing the key points of the proposed guidelines to optimize infection control and minimize the possibility of transmission throughout the surgical process.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Mata Estévez" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Mata Estévez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935620302875" "doi" => "10.1016/j.redar.2020.11.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935620302875?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192921000214?idApp=UINPBA00004N" "url" => "/23411929/0000006800000002/v1_202103160736/S2341192921000214/v1_202103160736/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial article</span>" "titulo" => "Intraoperative neurophysiological monitoring, personalized medicine and teamwork" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "55" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "N. Fàbregas Julià" "autores" => array:1 [ 0 => array:3 [ "nombre" => "N." "apellidos" => "Fàbregas Julià" "email" => array:1 [ 0 => "fabregas@clinic.cat" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Consultor sénior, Profesor asociado, Servicio de Anestesiología y Reanimación, Departamento de Cirugía y Especialidades Medicoquirúrgicas, Hospital Clínic Universitari de Barcelona, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Monitorización neurofisiológica intraoperatoria, medicina personalizada y trabajo en equipo" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">One of the aims of perioperative medicine is without a doubt the detection and prevention of events that can cause injury to both the central and peripheral nervous systems. The more physiological parameters we record, the more we appreciate the importance of monitoring and the more we improve patient safety. Neuromuscular monitoring, of paramount importance in anaesthesiology, includes the monitoring of neuromuscular blockade (NMB), depth of hypnosis, peripheral nervous system, and also intraoperative neurophysiological monitoring.</p><p id="par0010" class="elsevierStylePara elsevierViewall">NMB monitoring has been part of our daily practice for many years, although it is used less use than experts recommend<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. It contributes to the safe use of NMB agents and reduces the risk of NMB-related respiratory complications. In a recent consensus document, both anaesthesiologists and surgeons recommended using NMB monitoring in procedures requiring deep prolonged nerve block<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Processing electroencephalographic signals to monitor the depth of hypnosis is now also part of routine clinical practice, and allows us, for example, to reduce the risk of postoperative complications<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a>.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Anaesthesiologists are aware of the importance of preventing perioperative peripheral nerve injury due to extreme positions or nerve blockade. Since 1990, when records began, perioperative peripheral nerve injuries have accounted for 12% of claims for postoperative injury in the United States<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. The incidence of these injuries in the general surgical population is less than 1%, being more frequent after cardiac surgery, neurosurgery and some orthopaedic procedures. The aetiology is multifactorial, including different stretch, compression, ischaemia, and inflammation mechanisms. The severity and duration of the injury together with each patient’s neural reserve will determine the extent of the neurological outcome<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>. Patient positioning during surgery is the responsibility of the entire surgical team. A recently developed automated system for monitoring somatosensory evoked potentials to detect nerve ischaemia and prevent peripheral neurological injury has been used in cardiac<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and orthopaedic<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> surgery. Many studies had been published on strategies to reduce the complications associated with nerve blocks performed for regional anaesthesia or analgesia<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>, including nerve localisation methods, timing of blocks, needle techniques, and the choice of local anaesthetic and adjunct. It is difficult to ascertain the incidence of these complications, as they are usually diagnosed with some delay and outcomes vary greatly according to the study and the type of surgery. Anaesthesia-related nerve injury could affect up to 2.2% of patients 3 months after the procedure, up to 0.8% at 6 months and 0.2% at 1 year<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>. Several improvements are needed to reduce these complications, including the widespread use of new techniques for locating nerve structures, the use of new anaesthetic agents, and the development of surgical techniques<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Intraoperative neurophysiological monitoring (IONM) involves the use of physiological monitoring techniques to assess neural integrity and/or map or neuro-navigate within at-risk neural structures during various surgical procedures<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>. It is routinely used in neurosurgery to treat brain conditions<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> (brain and skull base) and diseases of the spine, spinal tumours and degenerative diseases such as scoliosis<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>. It is included in interventions involving lesions located close to eloquent areas or to ascending and descending sensory and motor tracts. In these procedures, IONM has proven useful in widening the extent of resection while preventing postoperative neurological deficits.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Although IONM is frequently associated with brain or spinal procedures, it is now used in many different surgeries and surgical specialties, such as cardiovascular surgery, general and digestive surgery, trauma, and ear, nose and throat surgery. As described in the special article by Aldana et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>, it is also used in thyroid and parotid surgery, carotid endarterectomies, open or minimally invasive thoracic aorta surgery, hip surgery, among others, IONM is performed by a team made up of neurophysiologists and neurophysiology technicians who work closely with surgeons, nurses, and anaesthesiologists. Multidisciplinary consensus documents, such as the one prepared by the Neuroscience Section of SEDAR together with the Spanish Intraoperative Neurophysiological Monitoring Association (<a href="https://monitorizacionintraoperatoria.com/">https://monitorizacionintraoperatoria.com/</a>) and published in this issue of the <span class="elsevierStyleSmallCaps">Spanish Journal of Anaesthesiology and Resuscitation</span><a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> play an important role in disseminating IONM protocols that can be followed by inexperienced surgical teams and teams that do not perform these procedures frequently enough. Continuous professional training promoted by scientific societies improves patient safety.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The development of new monitoring devices that generate fewer artifacts has contributed to their increased presence in the operating room and contributes to patient safety; however, conclusive evidence of their impact on clinical outcomes is often missing. Ongoing improvements in technology and accessories give more accurate recordings, although some still need to be improved, and more evidence is also needed to define the sensitivity and specificity of each monitoring technique used in different procedures.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In order for the surgical team to function correctly and achieve the best outcomes, all team members needs know what role each of their colleagues plays. The team needs to agree on the surgery plan, communicate effectively, and share information in order to create a climate of mutual trust and respect focussed on the patient. The team must be aware of the different contexts and/or events that can alter the quality of the recorded signals. As Aldana et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> mention in their consensus document, the reliability and accuracy of IONM to signal changes can be difficult to interpret. Understanding the limitations of IONM and the evidence supporting its use is therefore of great importance. The correct interpretation of neuromonitoring records will depend on the surgical team’s awareness of factors that can affect the recordings. Some manoeuvres are more likely to cause injury, and precautions must be taken to avoid iatrogenic lesions. When there is evidence of an alteration in the neurophysiological signal, each member of the team must question whether their actions might have contributed to the situation. All those involved in the treatment of a specific patient during a specific intervention under the coordination of the neurophysiologist must take steps to avoid false positives. Structured training in neurophysiological monitoring should be made available to surgeons and anaesthesiologists in order to reduce the generation of artifacts caused by certain surgical manipulations or anaesthetic techniques<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>. Anaesthesiologists are responsible for maintaining each patient’s vital signs within their "personalized range". As mentioned in the consensus document<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>, there is a growing body of evidence that certain values that have hitherto been regarded as standard, such as the lower limit of cerebral autoregulation, vary from one patient to another. In some patients there is no applicable standard of care, so surgery must be guided by IONM on the basis of changes in post-induction recordings over baseline values.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Another factor to take into account is that technological advances have led to the widespread implementation of minimally invasive surgical techniques. Although these can contribute to rapid postoperative recovery, in certain cases they can lead to an increase in iatrogenesis. One example of this is endoscopic microdiscectomy, in which outcomes are similar to open microdiscectomy<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>, but limited anatomical exposure carries an increased risk of injury to nerve structures<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>. IONM has becomes an essential tool for surgeons who in some procedures, such as the latest percutaneous approaches, do not have direct vision of nerve roots and are therefore unable to immediately detect direct or indirect injury that can cause a postoperative deficit. Another example is robotic transaxillary thyroid surgery, in which considerably shorter vagus nerve-evoked latencies have been observed in right-sided thyroid approaches compared to the open approach<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>. IONM is recommended in complex high-risk hip surgeries, such as those requiring prolonged surgical time, and those performed in morbidly obese patients or with pre-existing neuropathies<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>. In pelvic surgery in general and rectal cancer surgery in particular, direct visualization may be compromised for a variety of reasons, and IONM of pelvic autonomic nerves is performed in certain cases to avoid the risk of injury<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>.</p><p id="par0050" class="elsevierStylePara elsevierViewall">As in other areas of medicine, the automation and simplification of monitoring systems allows IONM techniques to be used without the physical presence of the neurophysiologist in certain procedures. In these cases, the technician can monitor the recordings telematically if required.</p><p id="par0055" class="elsevierStylePara elsevierViewall">There are several pressing questions anaesthesiologists will soon need to ask themselves: Should we accept as inevitable the appearance of neurological lesions related to surgical positioning, such as lithotomy or gynaecological surgery? Will preoperative evaluations be generalized in high-risk populations? Will patients undergoing different types of minimally invasive surgeries request perioperative IONM? We are probably witnessing the start of a trend towards widespread neurophysiological monitoring in surgical patients. We need to work closely with other clinicians to define the indications for IONM in different diseases and according to patient characteristics. Articles such as those by Aldana et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> provide a valuable introduction to these technique and raise awareness of the importance of teamwork and shared decision-making.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fàbregas Julià N. Monitorización neurofisiológica intraoperatoria, medicina personalizada y trabajo en equipo. Rev Esp Anestesiol Reanim. 2021;68:53–55.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bloqueo neuromuscular residual en la sala de recuperación postanestésica. Análisis secundario del estudio ReCuSS. Estudio observacional transversal de una cohorte multicéntrica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.L. Errando" 1 => "G. Mazzinari" 2 => "O. Díaz-Cambronero" 3 => "I. Garutti" 4 => "Grupo español de estudio del bloqueo neuromuscular" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2017.01.005" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2017" "volumen" => "64" "paginaInicial" => "419" "paginaFinal" => "422" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28341080" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Recomendaciones sobre el uso de bloqueo neuromuscular profundo por parte de anestesiólogos y cirujanos. Consenso AQUILES (Anestesia Quirúrgica para Lograr Eficiencia y Seguridad)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.L. Errando-Oyonartea" 1 => "C. Moreno-Sanz" 2 => "P. Vila-Caral" 3 => "J.C. Ruiz de Adana-Belbel" 4 => "E. Vázquez-Alonso" 5 => "J.M. Ramírez-Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2016.08.002" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2017" "volumen" => "64" "paginaInicial" => "95" "paginaFinal" => "104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27692692" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Processed electroencephalogram and evoked potential techniques for amelioration of postoperative delirium and cognitive dysfunction following non-cardiac and non-neurosurgical procedures in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. Punjasawadwong" 1 => "W. Chau-in" 2 => "M. Laopaiboon" 3 => "S. Punjasawadwong" 4 => "P. Pin-on" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Cochrane Database Syst Rev" "fecha" => "2018" "volumen" => "5" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Australian and New Zealand College of Anaesthetists Clinical Trials Network; Balanced Anaesthesia Study Group anaesthetic depth and complications after major surgery: an international, randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.G. Short" 1 => "D. Campbell" 2 => "C. Frampton" 3 => "M.T.V. Chan" 4 => "P.S. Myles" 5 => "T.B. Corcoran" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(19)32315-3" "Revista" => array:7 [ "tituloSerie" => "Lancet" "fecha" => "2019" "volumen" => "394" "paginaInicial" => "1907" "paginaFinal" => "1914" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31645286" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1470204512702693" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perioperative peripheral nerve injury after general anesthesia: a qualitative systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Chui" 1 => "J.M. Murkin" 2 => "K.L. Posner" 3 => "K.B. Domino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/ANE.0000000000003420" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2018" "volumen" => "127" "paginaInicial" => "134" "paginaFinal" => "143" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29787414" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peripheral nerve injury arising in anaesthesia practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.W. Hewson" 1 => "N.M. Bedforth" 2 => "J.G. Hardman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/anae.14140" "Revista" => array:6 [ "tituloSerie" => "Anaesthesia" "fecha" => "2018" "volumen" => "73" "paginaInicial" => "51" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29313904" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A novel automated somatosensory evoked potential (SSEP) monitoring device for detection of intraoperative peripheral nerve injury in cardiac surgery: a clinical feasibility study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Chui" 1 => "J.M. Murkin" 2 => "T. Turkstra" 3 => "N. McKenzie" 4 => "L. Guo" 5 => "M. Quantz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.jvca.2016.11.024" "Revista" => array:6 [ "tituloSerie" => "J Cardiothorac Vasc Anesth" "fecha" => "2017" "volumen" => "31" "paginaInicial" => "1174" "paginaFinal" => "1182" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28159523" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A pilot study of a novel automated somatosensory evoked potential (SSEP) monitoring device for detection and prevention of intraoperative peripheral nerve injury in total shoulder arthroplasty surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Chui" 1 => "J.M. Murkin" 2 => "D. Drosdowech" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ANA.0000000000000505" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg Anesthesiol" "fecha" => "2019" "volumen" => "31" "paginaInicial" => "291" "paginaFinal" => "298" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29787402" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The second ASRA practice advisory on neurologic complications associated with regional anesthesia and pain medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Neal" 1 => "M.J. Barrington" 2 => "R. Brull" 3 => "A. Hadzic" 4 => "J.R. Hebl" 5 => "T.T. Horlocker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/AAP.0000000000000286" "Revista" => array:6 [ "tituloSerie" => "Reg Anesth Pain Med" "fecha" => "2015" "volumen" => "40" "paginaInicial" => "401" "paginaFinal" => "430" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26288034" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neurological adverse events following regional anesthesia administration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.D. Kent" 1 => "L. Bollag" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2147/LRA.S8177" "Revista" => array:6 [ "tituloSerie" => "Local Reg Anesth" "fecha" => "2010" "volumen" => "3" "paginaInicial" => "115" "paginaFinal" => "123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22915878" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Practice guidelines for the supervising professional: intraoperative neurophysiological monitoring" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.H. Gertsch" 1 => "J.J. Moreira" 2 => "G.R. Lee" 3 => "J.D. Hastings" 4 => "E. Ritzl" 5 => "M.A. Eccher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10877-018-0201-9" "Revista" => array:6 [ "tituloSerie" => "J Clin Monit Comput" "fecha" => "2019" "volumen" => "33" "paginaInicial" => "175" "paginaFinal" => "183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30374759" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consideraciones preoperatorias y manejo neuroanestesiológico intraoperatorio" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Iturri Clavero" 1 => "C. Honorato" 2 => "I. Ingelmo Ingelmo" 3 => "N. Fàbregas Julià" 4 => "P. Rama-Maceiras" 5 => "R. Valero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2012.01.002" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2012" "volumen" => "59" "paginaInicial" => "3" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22429629" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for the use of electrophysiological monitoring for surgery of the human spinal column and spinal cord" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.N. Hadley" 1 => "C.D. Shank" 2 => "C.J. Rozzelle" 3 => "B.C. Walters" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/neuros/nyx466" "Revista" => array:6 [ "tituloSerie" => "Neurosurgery" "fecha" => "2017" "volumen" => "81" "paginaInicial" => "713" "paginaFinal" => "732" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29029325" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Documento de consenso para la monitorizacion nerofisiológica intraoperatoria multimodal en procedimientos neuroquirúrgicos. Fundamentos básicos" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Aldana" 1 => "N. Álvarez López-Herrero" 2 => "H. Benito" 3 => "M. Colomina" 4 => "J. Fernandez-Candil" 5 => "M. García Orellana" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redar.2020.02.010" "Revista" => array:2 [ "tituloSerie" => "Rev Esp Anestesiol Reanim" "fecha" => "2020" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Introduction of intraoperative neuromonitoring does not necessarily improve overall long-term outcome in elective aneurysm clipping" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Greve" 1 => "V.M. Stoecklein" 2 => "F. Dorn" 3 => "S. Laskowski" 4 => "N. Thon" 5 => "J.C. Tonn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3171/2018.12.JNS182177" "Revista" => array:6 [ "tituloSerie" => "J Neurosurg" "fecha" => "2020" "volumen" => "132" "paginaInicial" => "1188" "paginaFinal" => "1196" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30925469" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of surgical invasiveness between microdiscectomy and 3 different endoscopic discectomy techniques for lumbar disc herniation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.C. Choi" 1 => "H.K. Shim" 2 => "J.S. Hwang" 3 => "S.H. Shin" 4 => "D.C. Lee" 5 => "H.H. Jung" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.wneu.2018.05.085" "Revista" => array:6 [ "tituloSerie" => "World Neurosurg" "fecha" => "2018" "volumen" => "116" "paginaInicial" => "e750" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29787880" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intraoperative neurophysiological monitoring during spinal surgery: technical review in open and minimally invasive approaches" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Cofano" 1 => "F. Zenga" 2 => "M. Mammi" 3 => "R. Altieri" 4 => "M. Marengo" 5 => "M. Ajello" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10143-017-0939-4" "Revista" => array:6 [ "tituloSerie" => "Neurosurg Rev" "fecha" => "2019" "volumen" => "42" "paginaInicial" => "297" "paginaFinal" => "307" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29313181" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intraoperative neuromonitoring during thyroid surgery: the effect of surgical positioning" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.E. Crowther" 1 => "D.B. Ali" 2 => "J. Bamford" 3 => "S.W. Kang" 4 => "E. Kandil" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1553350618799786" "Revista" => array:6 [ "tituloSerie" => "Surg Innov" "fecha" => "2019" "volumen" => "26" "paginaInicial" => "77" "paginaFinal" => "81" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30196764" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multimodal neuromonitoring during safe surgical dislocation of the hip for joint preservation: feasibility, safety, and intraoperative observations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Scalone" 1 => "B. Bittersohl" 2 => "S. Karlsson" 3 => "J. Keenan" 4 => "H.S. Hosalkar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "JAAOS Glob Res Rev" "fecha" => "2017" "volumen" => "1" "paginaInicial" => "e038" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Continuous intraoperative monitoring of pelvic autonomic nerves during TME to prevent urogenital and anorectal dysfunction in rectal cancer patients (NEUROS): a randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.W. Kauff" 1 => "K. Kronfeld" 2 => "S. Gorbulev" 3 => "D. Wachtlin" 4 => "H. Lang" 5 => "W. Kneist" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12885-016-2348-4" "Revista" => array:5 [ "tituloSerie" => "BMC Cancer" "fecha" => "2016" "volumen" => "16" "paginaInicial" => "323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27209237" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006800000002/v1_202103160736/S234119292100024X/v1_202103160736/en/main.assets" "Apartado" => array:4 [ "identificador" => "62207" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorial article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006800000002/v1_202103160736/S234119292100024X/v1_202103160736/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234119292100024X?idApp=UINPBA00004N" ]
