Martin Almquist1, Mark Thier1, Farhad Salem1. 1. Department of Surgery, Skåne University Hospital, Lund, Sweden; and Institution for Clinical Sciences, Lund University, Lund, Sweden.
Abstract
BACKGROUND: Intraoperative neuromonitoring (IONM) is widely used during thyroid surgery. During both intermittent and continuous IONM stimulation of the vagus nerve is performed. This has previously been reported to be safe. METHODS: We present our findings based on the case reports of 2 patients. RESULTS: IONM of the recurrent laryngeal nerve (RLN), following the standards of the International Neuromonitoring Study Group, was conducted in 2 patients, one undergoing thyroid surgery and the second parathyroid surgery. In both cases, after dissection and stimulation of the vagus nerve on 1 mAmp, the patients became asystolic. Resuscitation efforts were successful in both patients. CONCLUSION: These 2 cases demonstrate that stimulation of the vagus nerve during IONM can lead to profound cardiac events. Consideration should be given to these potential complications when utilizing IONM.
BACKGROUND: Intraoperative neuromonitoring (IONM) is widely used during thyroid surgery. During both intermittent and continuous IONM stimulation of the vagus nerve is performed. This has previously been reported to be safe. METHODS: We present our findings based on the case reports of 2 patients. RESULTS: IONM of the recurrent laryngeal nerve (RLN), following the standards of the International Neuromonitoring Study Group, was conducted in 2 patients, one undergoing thyroid surgery and the second parathyroid surgery. In both cases, after dissection and stimulation of the vagus nerve on 1 mAmp, the patients became asystolic. Resuscitation efforts were successful in both patients. CONCLUSION: These 2 cases demonstrate that stimulation of the vagus nerve during IONM can lead to profound cardiac events. Consideration should be given to these potential complications when utilizing IONM.
Authors: E O Gür; M Haciyanli; S Karaisli; S Haciyanli; E Kamer; T Acar; Y Kumkumoglu Journal: Ann R Coll Surg Engl Date: 2019-06-20 Impact factor: 1.891