A New Methodology for Intraoperative Monitoring of the Functional Integrity of the Phrenic Nerve During Cardiothoracic Surgery

• Published in: Journal of clinical neurophysiology Vol. 38; no. 3; p. 226
• Main Authors: Lucente, Giuseppe, Martinez-Barenys, Carlos, Ramos-Fransi, Alba, Almendrote-Muñoz, Miriam, López de Castro, Pedro, Deletis, Vedran, Coll-Canti, Jaume, Martínez-Piñeiro, Alicia
• Format: Journal Article
• Language: English
• Published: United States 01.05.2021
• ISSN: 1537-1603
• DOI: 10.1097/WNP.0000000000000677

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. 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. 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. We reported a new methodology which allows the assessment of phrenic nerve functional integrity during surgical procedures.