Related Experiment Video
Updated: Mar 26, 2026

Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
Published on: February 11, 2019
Cardiac arrest with vagal stimulation during intraoperative nerve monitoring
Martin Almquist1, Mark Thier1, Farhad Salem1
1Department of Surgery, Skåne University Hospital, Lund, Sweden; and Institution for Clinical Sciences, Lund University, Lund, Sweden.
Background:
Intraoperative neuromonitoring (IONM) is widely used during thyroid surgery. During both intermittent and continuous IONM stimulation of the vagus nerve is performed. This has previously been reported to be safe.
Methods:
We present our findings based on the case reports of 2 patients.
Results:
IONM of the recurrent laryngeal nerve (RLN), following the standards of the International Neuromonitoring Study Group, was conducted in 2 patients, one undergoing thyroid surgery and the second parathyroid surgery. In both cases, after dissection and stimulation of the vagus nerve on 1 mAmp, the patients became asystolic. Resuscitation efforts were successful in both patients.
Conclusion:
These 2 cases demonstrate that stimulation of the vagus nerve during IONM can lead to profound cardiac events. Consideration should be given to these potential complications when utilizing IONM. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2419-E2420, 2016.
Related Concept Videos
Cardiopulmonary Resuscitation IV: Pharmacological Management
Cardiomyopathy VII: Pre and Post Operative Nursing Management
Cardiac Catheterization IV: Nursing Management
Local Anesthetics: Differential Sensitivity of Nerve Fibers
General Anesthesia: Overview
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
Stages of General Anesthesia

