Evidence map›Paper›PMID 27138019›Full record

Observational studyLangenbeck's archives of surgery2016

Continuous intraoperative monitoring of vagus and recurrent laryngeal nerve function in patients with advanced atrioventricular block.

Rick Schneider, Andreas Machens, Michael Bucher, Christoph Raspé, Konstantin Heinroth, Henning Dralle

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Langenbeck's archives of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Article
  2. Review
  3. Observational
  4. Article
  5. Review
  6. Review
  7. Review
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rick SchneiderDepartment of General, Visceral, and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany. rick.schneider@uk-halle.de.
Andreas MachensDepartment of General, Visceral, and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany.
Michael BucherDepartment of Anesthesiology and Surgical Intensive Care, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Christoph RaspéDepartment of Anesthesiology and Surgical Intensive Care, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Konstantin HeinrothDepartment of Internal Medicine, Division of Cardiology, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
Henning DralleDepartment of General, Visceral, and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntraoperative neuromonitoring of recurrent laryngeal nerve function after stimulation of the vagus nerve has been embraced as a risk minimization tool in thyroid surgery to prevent recurrent laryngeal nerve injury. Because this technology is increasingly used in an elderly and sicker population, the present study was conducted to determine the safety of this method in patients with second- or third-degree atrioventricular block.

methodsThis study aimed at evaluating the feasibility and safety of continuous intraoperative neuromonitoring (CIONM) in patients with second- or third-degree atrioventricular block.

resultsA total of six patients (12 nerves at risk), accounting for 0.3 % of all 1800 patients (3049 nerves at risk) who underwent thyroid surgery during the study period, were found to have second- or third-degree atrioventricular block. All these patients maintained normal systolic and diastolic blood pressures; heart rate; and peripheral arterial oxygen saturation before, during, and after CIONM. No clinically relevant changes in heart rate or blood pressure, cardiac arrhythmia, or other hemodynamically important events were noted despite careful monitoring of these patients. There was no interference between the biphasic waveform of the vocal muscle electromyogram and the spikes generated by the implanted cardiac pacemakers. Outcomes were uneventful with normal vocal fold and parathyroid gland function.

conclusionsWithin the limitations of this series and considering experimental, animal, and human data, continuous IONM of the vagus nerve at ≤2 Hz seems to be reasonably safe. Additional research is warranted to confirm these results in larger groups of patients with advanced atrioventricular block.

Indexed as

Monitoring, IntraoperativeThyroidectomyAgedAtrioventricular BlockFemaleHumansMaleMiddle AgedPacemaker, ArtificialRecurrent Laryngeal NerveThyroid DiseasesVagus NerveAV blockCardiac side effectsContinuous intraoperative neuromonitoringImplanted cardiac pacemakerThyroid surgeryVagus nerve stimulation

Identifiers

PMID27138019

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.