Version June 2024
| Anesthesia |
| Halogenated agents, nitrous oxide |
| Added agent Change in concentration |
| IV agents |
| Bolus dose Change infusion Dose wearing off Muscle relaxation change |
| Epidural, intrathecal, or regional block |
| Physiology |
| Temperature |
| Whole body temperature Local change (irrigation, cold IV fluids) |
| Ventilation |
| Hypoxemia Hyper or hypoventilation |
| Ischemia/reduced blood flow |
| Hypotension, poor cardiac output, bleeding Local ischemia (retractor, clip, vasospasm) Rheology/blood volume (change HCT, colloids) Loss autoregulation (hypoxia, hypercarbia, injury) Vascular steal/Robin Hood |
| Other |
| Raised intracranial, CSF, or tissue pressure Hypoglycemia, electrolyte abnormalities |
| Positioning |
| Mechanical stretch/pressure on plexus/nerves Vascular occlusion to area |
| Surgical |
| Blunt or surgical trauma Mechanical effect (device, retractor, pledget pressure) Vascular occlusion to area Applied medications surface or intravascular (lidocaine, papaverine) Surgical stimulation Tissue resection |
| Technical |
| Stimulation |
| Electrodes – Dislodged, edema, wrong location |
| Recording |
| Electrodes – Dislodged, edema, wrong location Poor or mismatched impedance Electrical noise from new equipment Myoclonus or seizures |
| Machine |
| Malfunction Display settings changed Testing paradigm settings changed |
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