小児における術中神経モニタリング

Intraoperative Neurophysiological Monitoring in Pediatric Patients

Point

・小児における術中神経モニタリングの対象年齢は年々若年化している．

・低年齢であるほど，髄鞘形成やシナプス結合が未成熟であるため，特に2歳未満の小児は伝導速度が遅く，高い刺激強度を要する．

・小児では麻酔の深度や血行動態を一定に維持することが困難なことが多く，安定した波形を得ることが難しい．

　Because of technological advancements in preserving neurological function during surgery, intraoperative neurophysiological monitoring has become mandatory and increasingly common. Few studies have reported on the safety, feasibility, and reliability of intraoperative neurophysiological monitoring in children, especially infants. The maturation of nerve pathways is not fully achieved until 2 years of age. Moreover, it is often difficult to maintain stable anesthetic depth and hemodynamic status when operating on children. The interpretation of neurophysiological recordings in children is different from that in adults and requires further consideration.