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Effect of phrenic nerve palsy on early postoperative lung function after pneumonectomy : a prospective study . BACKGROUND The issue of phrenic nerve preservation during pneumonectomy is still an unanswered question . So far , its direct effect on immediate postoperative pulmonary lung function has never been evaluated in a prospective trial . METHODS We conducted a prospective crossover study including 10 patients undergoing pneumonectomy for lung cancer between July 2011 and July 2012 . After written informed consent , all consecutive patients who agreed to take part in the study and in whom preservation of the phrenic nerve during operation was possible , were included in the study . Upon completion of lung resection , a catheter was placed in the proximal paraphrenic tissue on the pericardial surface . After an initial phase of recovery of 5 days all patients underwent ultrasonographic assessment of diaphragmatic motion followed by lung function testing with and without induced phrenic nerve palsy . The controlled , temporary paralysis of the ipsilateral hemidiaphragm was achieved by local administration of lidocaine 1 % at a rate of 3 mL/h ( 30 mg/h ) via the above-mentioned catheter . RESULTS Temporary phrenic nerve palsy was accomplished in all but 1 patient with suspected catheter dislocation . Spirometry showed a significant decrease in dynamic lung volumes ( forced expiratory volume in 1 second and forced vital capacity ; p < 0.05 ) with the paralyzed hemidiaphragm . Blood oxygen saturation levels did not change significantly . CONCLUSIONS Our results show that phrenic nerve palsy causes a significant impairment of dynamic lung volumes during the early postoperative period after pneumonectomy . Therefore , in these already compromised patients , intraoperative phrenic nerve injury should be avoided whenever possible .
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Intervention_Surgical
pneumonectomy
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Intervention_Surgical
pneumonectomy
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Intervention_Other
ultrasonographic
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Participant_Condition
pneumonectomy
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Participant_Sample-size
10
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Participant_Condition
pneumonectomy
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Participant_Condition
lung cancer
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Participant_Condition
phrenic nerve