Neuromuscular Electrical Stimulation for Venous Thromboembolism Prophylaxis and Its Effects on Somatosensory-Evoked Potentials: A Pretrial Study of a New, U.S. Food and Drug Administration-Approved Device
Document Type
Article
Abstract
BACKGROUND: Neuromuscular electrical stimulation (NMES) has emerged as a viable alternative for venous thromboembolism prophylaxis. Electrical stimulation of the peroneal nerve using NMES may potentially interfere with somatosensory-evoked potential (SSEP) acquisition. This feasibility study evaluates a NMES device and its effect on SSEP acquisition as an initial step in a randomized clinical trial to assess NMES for intraoperative venous thromboembolism prophylaxis. METHODS: Healthy volunteers underwent SSEP testing during NMES in an outpatient setting. Concurrently, SSEP recordings of the posterior tibial nerve with stimulation at each ankle were obtained in 3 conditions: sham, NMES in place but inactive; ipsi, NMES active on leg ipsilateral to SSEP acquisition; and contra, NMES active on the leg contralateral to SSEP acquisition. Nonparametric statistical methods, including repeated measures, were used for data analysis. RESULTS: Stimulation intensities on the left, right, and bilaterally did not differ (P ≥ 0.20). Strong positive correlations were noted between the ipsilateral geko stimulus pulse width and ipsilateral SSEP stimulation intensities (left: r = 0.866, P = 0.001; right: r = 0.877, P = 0.001). Women required significantly greater pulse width settings than men (P = 0.01). Finally, visual inspection of waveforms, as used during dynamic IONM, did not show any significant variations of P37 cortical waveforms during NMES. CONCLUSIONS: As a preliminary step to testing NMES intraoperatively for venous thromboembolism prophylaxis, interference with SSEP acquisition was investigated in the outpatient laboratory setting. Within a small sample of healthy volunteers, no significant changes were seen in P37 cortical latencies to suggest interference between the NMES device and SSEP waveforms.
Medical Subject Headings
Adult; Cerebral Cortex (physiology); Electric Stimulation Therapy (instrumentation, methods); Electroencephalography; Evoked Potentials, Somatosensory; Feasibility Studies; Female; Humans; Male; Middle Aged; Peroneal Nerve (physiology); Tibial Nerve (physiology); United States; United States Food and Drug Administration; Venous Thromboembolism (prevention & control); Young Adult
Publication Date
9-12-2020
Publication Title
World neurosurgery
E-ISSN
1878-8769
Volume
144
First Page
e605
Last Page
e611
PubMed ID
32916347
Digital Object Identifier (DOI)
10.1016/j.wneu.2020.09.025
Recommended Citation
Bohl, Michael A.; Newell, Christina A.; Shvarts, Vladimir; and Haque, Asim, "Neuromuscular Electrical Stimulation for Venous Thromboembolism Prophylaxis and Its Effects on Somatosensory-Evoked Potentials: A Pretrial Study of a New, U.S. Food and Drug Administration-Approved Device" (2020). Neurology. 719.
https://scholar.barrowneuro.org/neurology/719