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  • INTRAOPERATIVE

    MONITORING

    (in elective neurosurgery)

    Dr Nicolás de Riva Neuroanesthesia Division

    Anesthesiology Department

    Hospital Clinic de Barcelona

  • 2 Honorary Clinical Fellow, 2011

  • 3 Steiner LA at al. Crit Care Med. 2002 Apr;30(4):733-8

  • 4

  • 5

  • 6 2015 = ICM+™ Setting in Elective Neurosurgery Theatre

  • 7

    ‘How much monitoring time

    do we need?’

  • 8 81 y/o, HTN (ref 120/80 mmHg) ➔ Right CPA tumour

  • 9 Sitting surgery ➔ Venous air embolisms (3 episodes)

  • 10 8h surgery = 10h monitoring ➔ No NMBA (acoustic neuroma)

  • 11 8h surgery = 10h monitoring ➔ No NMBA (acoustic neuroma)

  • 12 Left MCA & Right ACA Aneurysm Clipping

  • 13 Left MCA & Right ACA Aneurysm Clipping

  • 14

    Using NIRS to calculate COx (‘cerebral oximetry index’) allows the retrospective calculation of the ABPOPT in patients undergoing elective neurosurgeries under general total intravenous anaesthesia (TIVA)

    HYPOTHESIS

  • 15

    AIMS

    1. To describe the possibility to monitor intraoperative CA non-invasively in elective neurosurgery (COx index).

    2. To determine the possibility to monitor individual ABPOPT

    3. To analyze the relation between ABPOPT and ABPINTRAOP

  • 16

    AIMS

    4. To analyze differences between ABPBASAL (preop), ABPINTRAOP and ABPOPT

    5. To analyze differences between surgeries

    (Supratentorial vs Infratentorial vs Vascular vs Spinal)

  • 17

  • 18

  • 19

    ‘Are we calculating ABPOPT the right way?’

  • 20

    ‘Are we calculating ABPOPT the right way?’

    • Single window

    • Multi-flexi window (Leuven)

  • 21 Thanks to Erta Beqiri

  • 22 Thanks to Erta Beqiri

  • 23

  • 24

    “One size does not fit all”

    SCARTD 2016, Barcelona

  • 25

    “One size does not fit all”

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