Intraoperative Monitoring of Evoked Potentials

  • Betty L. Grundy


Evoked potentials (EPs), the electrophysiologic responses of the nervous system to stimulation, permit monitoring of the functional integrity of neurologic pathways when clinical monitoring is hampered by general anesthesia or coma. Intraoperative EP monitoring is now commonplace in many medical centers throughout the world. To use these techniques to best advantage, one must appreciate several important principles. This paper reviews key concepts in monitoring and describes key criteria for assessing EPs as monitors in the operating room. In conclusion, guidelines for avoiding “false positives” and “false negatives” are outlined.


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  1. 1.
    Beecher HK (1940) The first anesthesia records (Codman, Cushing). Surg Gynecol Obstet 71: 689Google Scholar
  2. 2.
    Bendixen HH (1978) A forward: the tasks of the anesthesiologist. In: Saidman LJ, Smith NT (eds) Monitoring in anesthesia. Wiley, New York, pp 227–267Google Scholar
  3. 3.
    MacEwen GD, Bunnell WP, Sriram K (1975) Acute neurological complications in the treatment of scoliosis: a report of the Scoliosis Research Society. J Bone Joint Surg 57 A: 404Google Scholar
  4. 4.
    Steed DL, Peitzmann AB, Grundy BL et al (1982) Causes of stroke in carotid endarterectomy. Surgery 92: 634PubMedGoogle Scholar
  5. 5.
    Grundy BL, Lina A, Procopio PT, Jannetta PJ (1981) Reversible evoked potential changes with retraction of the eighth cranial nerve. Anesth Analg 60: 835PubMedGoogle Scholar
  6. 6.
    Grundy BL, Jannetta PJ, Procopio PT et al (1982) Intraoperative monitoring of brain-stem auditory evoked potentials. J Neurosurg 57: 674PubMedCrossRefGoogle Scholar
  7. 7.
    Mahla ME, Long DM, McKennett J, Green C et al (1984) Detection of brachial plexus dysfunction by somatosensory evoked potential monitoring — A report of two cases. Anesthesiology 60: 248PubMedCrossRefGoogle Scholar
  8. 8.
    Grundy BL (1982) Monitoring of sensory evoked potentials during neurosurgical operations: methods and applications. Neurosurgery 11: 556PubMedCrossRefGoogle Scholar
  9. 9.
    Grundy BL (1983) Intraoperative monitoring of sensory evoked potentials. Anesthesiology: 58: 72PubMedCrossRefGoogle Scholar
  10. 10.
    Gravenstein MA, Sasse F, Hogan K (1984) Effects of stimulus rate and halothane dose on canine far-field evoked potentials. Anesthesiology 61: A 342Google Scholar
  11. 11.
    Friedman WA, Grundy BL (1987) Monitoring of sensory evoked potentials is highly reliable and helpful in the operating room. J Clin Monit 3: 38PubMedCrossRefGoogle Scholar
  12. 12.
    Grundy BL, Procopio PT, Jannetta PJ et al (1982) Evoked potential changes produced by positioning for retromastoid craniectomy. Neurosurgery 10: 766PubMedCrossRefGoogle Scholar
  13. 13.
    Kaplan BJ, Friedman WA, Alexander JA, Hampson SR (1986) Somatosensory evoked potential monitoring of spinal cord ischemia during aortic operations. Neurosurgery 19: 82PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 1988

Authors and Affiliations

  • Betty L. Grundy
    • 1
  1. 1.Anesthesiology ServiceVeterans Administration Medical CenterGainesvilleUSA

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