Hemodynamic stability during laryngeal electromyography procedures

Abstract

Background: Laryngeal electromyography (LEMG) is accepted as safe, with minimal side effects. However, patient hemodynamic stability, during these procedures, has not been reported. This study aimed to investigate the hemodynamics in patients undergoing LEMG and determine the risk factors for hemodynamic changes.

Methods: We recruited 89 consecutive patients who underwent LEMG. Baseline and postprocedural changes in vital signs were analyzed.

Results: Diastolic blood pressure (DBP) increased from 75.08 ± 11.54 mmHg preprocedure to 77.4 ± 11.91 mmHg postprocedure (p = .006); pulse rate (PR) increased from 78.1 ± 13.3 beats per minute preprocedure to 80.02 ± 13.69 postprocedure (p = .027). Systolic blood pressure (SBP) and oxygen saturation were unchanged after the procedure. However, about 17% of patients experienced profound changes in vital signs of >20% above baseline during LEMG. The hemodynamic changes did not differ between sexes or between surgical and non-surgical etiologies of vocal fold paralysis. Two patients experienced profound but reversible near-syncope during the procedure.

Conclusions: LEMG is a safe procedure with few immediate complications, though it may affect the patient’s hemodynamic status by increasing DBP and PR. The hemodynamic monitoring is recommended so that timely intervention can be applied in case any warning sign occurs.

Chinese abstract

背景：喉肌电图（LEMG）被认为是安全的, 副作用很小。然而, 在这些手术过程中患者的血液动力学稳定性尚未得到报道。本研究旨在调查接受LEMG的患者的血液动力特征, 并确定血液动力学变化的危险因素。

方法：我们招募了89例接受LEMG的连续患者, 分析了生命体征的基线和术后变化。

结果：舒张压（DBP）从术前75.08 ± 11.54 mmHg提高至术后77.4 ± 11.91 mmHg（p = .006）;脉搏率（PR）从预测的每分钟78.1 ± 13.3次提高到术后80.02 ± 13.69（p = 0.027）。手术后收缩压（SBP）和血氧饱和度不变。然而, 约17%的患者在LEMG期间经历了基线之上高出20%的生命体征的重大变化。血液动力学变化在性别之间或声带折叠麻痹的手术和非手术病因之间没有差异。两名患者在手术过程中经历了深度但可逆转的近晕厥。

结论：LEMG是一种安全的手术, 很少有有即刻并发症, 虽然它可能会通过提高DBP和PR来影响患者的血液动力学状态。建议进行血液动力学监测, 以便在出现任何警告信号的情况下及时干预。

Keywords:

• Laryngeal electromyography
• syncope
• monitoring
• hemodynamic
• hypertension

Acknowledgments

The authors thank Chia-Fan Chang and Li-Yun Lin for collecting the data. The research was supported by a National Science Council Grant (MOST103-2314-B- 182A-056-MY2) and a Chang Gung Medical Foundation Grant (CMRPG 3D1412 for personnel and consumables and CMRPG5D0161-4 for data analysis). The funders had no role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The research was supported by a National Science Council Grant (MOST103-2314-B- 182A-056-MY2) and a Chang Gung Medical Foundation Grant (CMRPG 3D1412 for personnel and consumables and CMRPG5D0161-4 for data analysis).