Peripheral Nerve Injury in Thoracic Surgery Detected by Automated Somatosensory Evoked Potential Monitoring.

<jats:p> Study Objective. Our objectives were to estimate the incidence of symptoms of peripheral nerve injury (sPNI) in thoracic surgical patients undergoing video-assisted thoracic surgery or open thoracotomy and to determine whether intraoperative somatosensory evoked potentials (SSEPs) waveform changes correlate with postoperative peripheral neuropathic symptoms. Methods. We conducted a prospective observational study in the operating room of a tertiary hospital. We measured SSEPs intraoperatively and assessed patients for sPNI postoperatively. Results. Forty-four patients consented. Six were excluded from analysis. We found that 42% (95% confidence interval [CI] = 26% to 57%) of patients undergoing thoracic surgery had significant changes in SSEP amplitude and latency. Furthermore, 16% (95% CI = 4% to 28%) of patients had new postoperative symptoms of sensory or motor deficits in an upper extremity. We calculated a sensitivity of 66.7% (95% CI = 29.0% to 100%) and a specificity of 50% (95% CI = 33% to 67.3%) for the identification of sPNI based on automated intraoperative SSEP changes. Conclusions. We identified the incidence of SSEP changes in thoracic surgery (42%) and the incidence of postoperative sPNI after thoracic surgery (16%). We identified a positive correlation between intraoperative SSEP changes and postoperative sPNI, which after multivariate analysis was not significant given the small sample size of the study. By the time sensory and/or motor changes are detected postoperatively, it may be too late to reverse the nerve damage. Future versions of the EPAD device could provide anesthesiologists a way to monitor for the development of sPNI, and make changes before a potential injury becomes permanent. /jats:p

Cios, Peripheral Nerve Injury in Thoracic Surgery Detected by Automated Somatosensory Evoked Potential Monitoring, 'Seminars in Cardiothoracic and Vascular Anesthesia' (24, 3) pp. 211-218. Copyright © 2020. DOI: 10.1177/1089253220919303. Users who receive access to an article through a repository are reminded that the article is protected by copyright and reuse is restricted to non-commercial and no derivative uses. Users may also download and save a local copy of an article accessed in an institutional repository for the user's personal reference. For permission to reuse an article, please follow our Process for Requesting Permission.

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Work Title Peripheral Nerve Injury in Thoracic Surgery Detected by Automated Somatosensory Evoked Potential Monitoring.
Access
Open Access
Creators
  1. Theodore J. Cios
  2. Shane M. Barre
  3. Sandeep Pradhan
  4. S. Michael Roberts
License CC BY-NC-ND 4.0 (Attribution-NonCommercial-NoDerivatives)
Work Type Article
Publisher
  1. SAGE Publications
Publication Date May 11, 2020
Publisher Identifier (DOI)
  1. 10.1177/1089253220919303
Source
  1. Seminars in Cardiothoracic and Vascular Anesthesia
Deposited September 09, 2021

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  • Added Creator Sandeep Pradhan
  • Added Creator S. Michael Roberts
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