{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:14:26Z","timestamp":1777936466757,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100008321","name":"pennsylvania state university","doi-asserted-by":"publisher","award":["NIH\/NCATS Grant Number UL1 TR000127 and UL1 TR0020"],"award-info":[{"award-number":["NIH\/NCATS Grant Number UL1 TR000127 and UL1 TR0020"]}],"id":[{"id":"10.13039\/100008321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Semin Cardiothorac Vasc Anesth"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Study Objective. Our objectives were to estimate the incidence of symptoms of peripheral nerve injury (sPNI) in thoracic surgical patients undergoing video-assisted thoracic surgery or open thoracotomy and to determine whether intraoperative somatosensory evoked potentials (SSEPs) waveform changes correlate with postoperative peripheral neuropathic symptoms. Methods. We conducted a prospective observational study in the operating room of a tertiary hospital. We measured SSEPs intraoperatively and assessed patients for sPNI postoperatively. Results. Forty-four patients consented. Six were excluded from analysis. We found that 42% (95% confidence interval [CI] = 26% to 57%) of patients undergoing thoracic surgery had significant changes in SSEP amplitude and latency. Furthermore, 16% (95% CI = 4% to 28%) of patients had new postoperative symptoms of sensory or motor deficits in an upper extremity. We calculated a sensitivity of 66.7% (95% CI = 29.0% to 100%) and a specificity of 50% (95% CI = 33% to 67.3%) for the identification of sPNI based on automated intraoperative SSEP changes. Conclusions. We identified the incidence of SSEP changes in thoracic surgery (42%) and the incidence of postoperative sPNI after thoracic surgery (16%). We identified a positive correlation between intraoperative SSEP changes and postoperative sPNI, which after multivariate analysis was not significant given the small sample size of the study. By the time sensory and\/or motor changes are detected postoperatively, it may be too late to reverse the nerve damage. Future versions of the EPAD device could provide anesthesiologists a way to monitor for the development of sPNI, and make changes before a potential injury becomes permanent.<\/jats:p>","DOI":"10.1177\/1089253220919303","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T04:07:13Z","timestamp":1589170033000},"page":"211-218","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Peripheral Nerve Injury in Thoracic Surgery Detected by Automated Somatosensory Evoked Potential Monitoring"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9729-0793","authenticated-orcid":false,"given":"Theodore J.","family":"Cios","sequence":"first","affiliation":[{"name":"Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane M.","family":"Barre","sequence":"additional","affiliation":[{"name":"Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8804-7898","authenticated-orcid":false,"given":"S. Michael","family":"Roberts","sequence":"additional","affiliation":[{"name":"Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,5,11]]},"reference":[{"key":"bibr1-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2001.tb00542.x"},{"key":"bibr2-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)36865-5"},{"key":"bibr3-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199301000-00006"},{"key":"bibr4-1089253220919303","doi-asserted-by":"publisher","DOI":"10.3389\/fncom.2016.00043"},{"key":"bibr5-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1097\/ANA.0000000000000505"},{"key":"bibr6-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2016.11.024"},{"key":"bibr7-1089253220919303","unstructured":"American Clinical Neurophysiology Society. Guideline 11B: recommended standards for intraoperative monitoring of somatosensory evoked potentials. https:\/\/www.acns.org\/pdf\/guidelines\/Guideline-11B.pdf. Accessed April 6, 2020."},{"key":"bibr8-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1016\/j.thorsurg.2015.07.012"},{"key":"bibr9-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1016\/0303-8467(91)90002-7"},{"key":"bibr10-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2010.12.034"},{"key":"bibr11-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2017.08.030"},{"key":"bibr12-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/79.4.440"},{"key":"bibr13-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(89)80085-0"},{"key":"bibr14-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1997.tb04798.x"},{"key":"bibr15-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awq252"},{"key":"bibr16-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2015.11.018"},{"key":"bibr17-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1016\/0363-5023(93)90362-7"},{"key":"bibr18-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000000841"},{"key":"bibr19-1089253220919303","doi-asserted-by":"publisher","DOI":"10.1098\/rsos.160254"}],"container-title":["Seminars in Cardiothoracic and Vascular Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1089253220919303","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1089253220919303","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1089253220919303","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:32:53Z","timestamp":1777692773000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1089253220919303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,11]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1177\/1089253220919303"],"URL":"https:\/\/doi.org\/10.1177\/1089253220919303","relation":{},"ISSN":["1089-2532","1940-5596"],"issn-type":[{"value":"1089-2532","type":"print"},{"value":"1940-5596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,11]]}}}