Objectives: The purpose of this paper is to increase awareness of electrode burns that occur in the operating room (OR), to discuss their causes, warning signs, and methods that may reduce their occurrence. Two general sources of electrical burns are described: 1) Excessive radio-frequency current density usually originating from a monopolar electrosurgical unit (ESU) and 2) Direct current (DC) originating from a battery or equipment malfunction.
Methods: Case examples associated with intraoperative neuromonitoring are provided and discussed in the context of the relevant literature. Seven cases are described, five associated with excessive radio-frequency current density and two associated with direct current originating from a battery or equipment malfunction.
Conclusions: Recommendations on prevention and warning signs associated with these burns are presented in addition to procedures to follow if a burn is suspected.