During a thoracic laminectomy, what should be the first response to rapid loss of right PTN cortical responses?

In the context of intraoperative monitoring during a thoracic laminectomy, the rapid loss of right posterior tibial nerve (PTN) cortical responses can indicate an urgent issue, such as changes in blood flow or neurological compromise. The first response to such an event requires immediate communication with the surgical team. Informing the surgeon promptly allows for timely intervention, addressing potential causes of the loss of response, such as retraction injuries, compression, or changes in perfusion that may be adversely affecting the neural structures.

Intraoperative neurophysiological monitoring is critical for patient safety, and rapid changes in monitoring signals need to be conveyed urgently to facilitate appropriate surgical adjustments or techniques that may prevent irreversible damage. Therefore, informing the surgeon is the proper course of action to ensure the patient's safety and the successful outcome of the procedure.

Reassessing electrode placement, increasing stimulation frequency, or switching monitoring techniques are actions that might be considered in other contexts, but they do not address the urgency of a potential neurological event as effectively as promptly alerting the surgical team. The immediacy of the communication is crucial in maintaining patient safety and properly responding to intraoperative changes in neurophysiological signals.