Comparison of Sugammadex Dose for Intraoperative Neuromonitoring in Thyroid Surgery: A Randomized Controlled Trial. (15th March 2021)

• Record Type: Journal Article
• Authors: Chai, Young Jun; Lee, Jung‐Man; Won, Dongwook; Lee, Jiwon; Hwang, Jin‐Young; Kim, Tae Kyong; Chang, Jee‐Eun; Kim, Hyerim; Yang, Hyo Jun; Min, Seong‐Won
• Is Part Of: Laryngoscope. Volume 131:Number 9(2021)
• Page Start: 2154
• Page End: 2159
• Publication Date: 2021-03-15
• Subjects: Neural monitoring -- recurrent laryngeal nerve -- sugammadex -- thyroid surgery -- vocal cord paralysis; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.29515
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objectives/Hypothesis: To compare effect of 1 and 2 mg/kg of sugammadex on the incidence of intraoperative bucking and intraoperative neuromonitoring (IONM) quality in thyroid surgery. Study Design: Randomized controlled trial. Methods: Patients qualified for thyroid surgery with IONM were eligible for this double‐blind, randomized, controlled trial. After tracheal intubation with 0.6 mg/kg rocuronium, 1 or 2 mg/kg of sugammadex was administered to patients in group I or II, respectively. The quality of the IONM for the external branch of the superior laryngeal nerve (EBSLN) was evaluated (strong/intermediate/weak). The initial amplitude of electromyography for the vagus nerve (V1) and the recurrent laryngeal nerve (R1) were recorded. Intraoperative bucking movements was recorded. Results: A total of 102 patients (51 in each group) completed the study. Time from sugammadex administration to initial checking for the EBSLN was not different between group I and II (25.0 ± 7.9 vs. 25.5 ± 9.0 minutes, P = .788). There was no difference in the neuromonitoring quality for the EBSLN between group I and II (strong/intermediate/weak: 46/5/0 vs. 50/1/0, P = .205). The amplitudes of V1 (1, 086.3 ± 673.3 μV vs. 1, 161.8 ± 727.5 μV, P = .588) and R1 (1, 328.2 ± 934.1 μV vs. 1, 410.5 ± 919.6 μV, P = .655) were comparable between the groups. Patients who experienced bucking were significantly fewer in the group I than the group II (13.7% vs. 35.3%, P = .020). Conclusion: A dose of 1 mg/kg sugammadex induced less bucking than 2 m/kg while providing comparable IONM quality during thyroid surgery. Level of Evidence: 2 Laryngoscope, 131:2154–2159, 2021