title: [Monitoring of recurrent laryngeal nerve injury using an electromyographic endotracheal tube in thyroid and parathyroid surgery. Anesthetic aspects].
abstract: Recurrent laryngeal nerve injury remains one of the main complications in thyroid and parathyroid surgery. When this injury is bilateral, an acute upper airway obstruction may occur, leading to a potentially life-threatening situation for the patient. The visual identification of the nerve during surgery is the best way to preserve its integrity. However identification of the nerves by means of electromyographic stimuli through electrodes attached to endotracheal tubes could help in decreasing nerve injury. In these cases the experience and role of the anesthetist is essential to correctly place the electromyographic endotracheal tube and ensure that the electrodes are in touch with the vocal cords during the surgery. Moreover, the results of the electromyography can be affected by the neuromuscular blocking agents. Therefore, the choice and dose must be adapted, in order to ensure a suitable anesthetic depth, and adequate response.
authors.affiliation: Departamento de Anestesiología y Reanimación, Hospital Universitario Doctor Peset, Valencia, España. Electronic address: jmartinjaramago@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Martín Jaramago
authors.forename: M
authors.initials: M
authors.lastname: Tamarit Conejeros
authors.forename: M
authors.initials: M
authors.lastname: Escudero Torrella
authors.forename: C
authors.initials: C
authors.lastname: Solaz Roldán
mesh_terms: D000758:Anesthesia; D004576:Electromyography / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D064795:Intraoperative Neurophysiological Monitoring / Q000295:instrumentation / Q000379:methods*; D007442:Intubation, Intratracheal / Q000295:instrumentation; D016105:Parathyroidectomy; D061226:Recurrent Laryngeal Nerve Injuries / Q000175:diagnosis* / Q000517:prevention & control*; D013965:Thyroidectomy
keywords: Acquired vocal cord palsy; Anestesia general; Bloqueante neuromuscular; General anesthesia; Intraoperative monitoring; Monitorización intraoperatoria; Nervio laríngeo recurrente; Neuromuscular blocker; Parálisis de cuerdas vocales; Recurrent laryngeal nerve; Thyroidectomy; Tiroidectomía