Feasibility of the enhanced neuromuscular blockade recovery protocol with selective use of sugammadex in thyroid surgery with intraoperative neuromonitoring.

Autor: Yang S; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China., Sun Z; Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China., Zhou C; Department of Cancer Prevention, Fudan University Shanghai Cancer Center, Shanghai, China., Wei W; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China., Qu N; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China., Shi R; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China., Ma B; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China., Xu W; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China., Ji Q; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China., Zhang J; Department of Anesthesiology, Fudan University Shanghai Cancer Center, Shanghai, China., Wang Y; Department of Head & Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.; Cancer Research Institute, Fudan University Shanghai Cancer Center, Shanghai, China.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Dec; Vol. 46 (12), pp. 2917-2925. Date of Electronic Publication: 2024 Jun 15.
DOI: 10.1002/hed.27826
Abstrakt: Background: To investigate feasibility of utilizing enhanced neuromuscular blocking agents with selective recovery protocol during thyroid surgery with intraoperative neuromonitoring (IONM).
Methods: Two-hundred and ninety patients were randomized into two groups: group A 0.3 mg/kg rocuronium and group B 0.6 mg/kg. Sugammadex 2 mg/kg was injected if needed followed initial vagal stimulation (V0). Electromyography signals from vagus and recurrent laryngeal nerves before and after resection were recorded as V1, V2, R1, and R2.
Results: In group B, 30 patients (20.7%) had V0 signals <100 μV, compared to 9 (6.2%) in group A. After sugammadex administration, 144 patients (99.3%) in both groups achieved positive V1 signals. Group B demonstrated a shorter surgical time from rocuronium injection to V2 stimulation compared to group A, accompanied by a significantly lower incidence of intraoperative body movement (0 vs. 16 patients).
Conclusions: 0.6 mg/kg rocuronium with selective use 2 mg/kg sugammadex for IONM in thyroid surgery can meet both anesthesia and surgery demands.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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