The usefullness of intraoperative check-lists and safety management for intraoperative neuro-monitoring

Abstract

Postoperative neurological dysfunction due to the surgical procedure is a serious problem. It directly impacts the patient’s activities of daily living. Intraoperative neuro-monitoring has an important role in prevention. For more reliable neuro-monitoring, it is necessary for surgeons, anesthesiologists, and surgical technicians involved in surgery to share information and knowledge during surgery. In 2015, our monitoring team introduced a preoperative checklist for sharing information during neuro-monitoring. We believe that this checklist facilitates more reliable and accurate neuro-monitoring. Furthermore, we made a new corresponding checklist and clinical algorithms after deterioration of intraoperative waveforms is detected. The purpose of this study was to review our clinical series retrospectively and clarify the usefulness of our checklist and clinical algorithms. We found that the percentage of false positive findings decreased from 12.06% to 0.94% after introduction of the checklists.