In which scenario can BAER waveforms not be recorded?

The ability to record Brainstem Auditory Evoked Responses (BAER) waveforms can be significantly affected by the conditions of the surgical environment and the patient's state. When bone drilling is performed, it produces intense vibrations and noise that can interfere with the delicate recordings of auditory evoked potentials. This process can introduce significant background noise and may overwhelm the signals that are produced by the brain in response to auditory stimuli. The vibrations from the drilling can also cause physical disruptions that affect electrode placement and recording quality, making it difficult or impossible to obtain clear BAER waveforms.

In contrast, tranquil sedation typically allows for clearer BAER recordings, as the patient is calm and less likely to generate interference from muscle movements or response to external stimuli. Adequate patient noise control can mitigate background noise and ensure that the auditory signals are not masked, thus allowing for successful waveform recording. When the patient is awake, although there may be challenges with movement or response to stimuli, it is still possible to record BAER waveforms if managed properly. Overall, performing procedures like bone drilling is the scenario where BAER waveforms are least likely to be recorded successfully due to the substantial interference created.