Impact of continuous intraoperative neuromonitoring on autonomic nervous system during thyroid surgery

Background. Continuous intraoperative neuromonitoring (CIONM) via vagal nerve stimulation (VNS) is a new option for recurrent laryngeal nerve (RLN) protection during thyroid surgery. The aim of this study was to evaluate the safety of VNS for CIONM and to assess its effects on the autonomic nervous...

Full description

Saved in:
Bibliographic Details
Published in:Head & neck 2011-07, Vol.33 (7), p.976-984
Main Authors: Ulmer, Christoph, Friedrich, Colin, Kohler, Andrea, Rieber, Fabian, Basar, Tarkan, Deuschle, Michael, Thon, Klaus-Peter, Lamadé, Wolfram
Format: Article
Language:English
Subjects:
Adult
Arrhythmia
Autonomic nervous system
Autonomic Nervous System - physiopathology
Biological and medical sciences
continuous intraoperative neuromonitoring
Electromyography
Female
Goiter - surgery
Head
Heart
Heart rate
Heart Rate - physiology
heart rate variability analysis
Hemodynamics
Humans
Male
Medical sciences
Middle Aged
Monitoring, Intraoperative - methods
Neck
Nervous system (semeiology, syndromes)
Nervous system as a whole
Neurology
Otorhinolaryngology. Stomatology
Parasympathetic nervous system
Parasympathetic Nervous System - physiopathology
Prospective Studies
recurrent laryngeal nerve palsy
Surgery
Thyroid
Thyroid Diseases - surgery
Thyroid Nodule - surgery
thyroid surgery
Thyroidectomy
vagal nerve stimulation
Vagus Nerve
Vocal Cord Paralysis - physiopathology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background. Continuous intraoperative neuromonitoring (CIONM) via vagal nerve stimulation (VNS) is a new option for recurrent laryngeal nerve (RLN) protection during thyroid surgery. The aim of this study was to evaluate the safety of VNS for CIONM and to assess its effects on the autonomic nervous system (ANS) through analyzing heart rate variability (HRV). Methods. In a prospective, nonrandomized controlled study 5 patients received VNS for CIONM and 5 were operated on with conventional intermittent intraoperative neuromonitoring (IONM). HRV was analyzed in accord with patient‐specific reference values. Results. VNS resulted in significantly altered ANS balance. Relative parasympathetic activity increased during VNS. Yet, no relevant cardiac arrhythmias or hemodynamic alterations were observed during VNS. Conclusion. HRV analysis revealed a distinct impact of VNS for CIONM on ANS balance. VNS caused parasympathetic predominance that was not countered by increased sympathetic activity. © 2010 Wiley Periodicals, Inc. Head Neck, 2011
ISSN:1043-3074
1097-0347
1097-0347
DOI:10.1002/hed.21564