A New Methodology for Intraoperative Monitoring of the Functional Integrity of the Phrenic Nerve During Cardiothoracic Surgery. Issue 3 (May 2021)

• Record Type: Journal Article
• Authors: Lucente, Giuseppe; Martinez-Barenys, Carlos; Ramos-Fransi, Alba; Almendrote-Muñoz, Miriam; López de Castro, Pedro; Deletis, Vedran; Coll-Canti, Jaume; Martínez-Piñeiro, Alicia
• Is Part Of: Journal of clinical neurophysiology. Volume 38:Issue 3(2021)
• Publication Date: 2021-05
• Subjects: Phrenic nerve -- Intraoperative monitoring -- Neurography -- Diaphragm palsy -- Thoracic surgery -- Phrenic nerve injury; Electroencephalography -- Periodicals; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electroencephalography; Periodicals; 612.805
• DOI: 10.1097/WNP.0000000000000677
• Languages: English
• ISSNs: 0736-0258

Abstract

Abstract : Introduction: The phrenic nerve could be easily injured during cardiothoracic surgeries because of its anatomical relationships. The aim of this study is to describe a new, feasible, and reproducible methodology to achieve a continuous intraoperative neuromonitoring of the phrenic nerve. Methods: Consecutive patients who underwent open-chest surgery were included. The recording active electrode was placed 5 cm superior to the tip of the xiphoid process, and a hook wire inserted at the motor point of the ipsilateral hemidiaphragm was used as the reference electrode. Results: We studied 45 patients (92% men, mean age 67 years). Mean height and weight were 167 ± 6.9 cm and 75.6 ± 12.3 kg, respectively. A reproducible compound motor action potential was recorded in 38 (85%) subjects. The mean latency and amplitude values were 9.68 ± 2.40 ms and 1.36 ± 3.83 mV, respectively. No intraoperative events were recorded. Conclusions: We reported a new methodology which allows the assessment of phrenic nerve functional integrity during surgical procedures.