Are pre-positional recordings valid as baselines for the surgical monitoring case?

Pre-positional recordings are typically considered unsuitable for establishing baselines in surgical monitoring cases because they may not accurately reflect the patient's neural status once the surgical positioning occurs. During surgery, especially after positioning, various physiological changes can occur that can alter the neurophysiological responses, making pre-positional recordings less reliable for interpretation during the actual procedure.

When a patient is positioned for surgery, the surgical factors—such as anesthesia effects, altered blood flow, and changes in pressure on neural structures—can significantly impact intraoperative neuromonitoring. Therefore, relying on recordings made before positioning may lead to misinterpretations of the patient's status during surgery, which can compromise the safety and efficacy of neurophysiological monitoring.

In comparison, baselines should ideally be established after the patient is positioned and stabilized under anesthesia to ensure accurate representation of the patient's neural function throughout the surgical procedure. This context emphasizes the importance of obtaining recordings that truly reflect the patient's condition during surgery rather than before it.