Background The use of neuromuscular blocking agents may affect intraoperative neuromonitoring during thyroid surgery. A selective neuromuscular recovery protocol was evaluated in a retrospective cohort study during human thyroid neural monitoring surgery. Methods One hundred and twenty-ﬁve consecutive patients undergoing thyroidectomy with intraoperative neu- romonitoring followed a selective neuromuscular block recovery protocol—single intubating dose of rocuronium followed by sugammadex if needed at the ﬁrst vagal stimulation (V1). Results Data from 120 of 125 patients could be analysed. Fifteen (12.5%) patients needed sugammadex reversal to obtain an EMG response at the ﬁrst vagal stimulation (V1). In the remaining 105 patients, spontaneous recovery of rocuronium-induced neuromuscular block was sufﬁcient for a successful ﬁrst vagal stimulation (V1). Conclusions In patients undergoing thyroid surgery, routine reversal of rocuronium block with sugammadex is not mandatory for reliable intraoperative neuromonitoring. A selective neuromuscular block recovery approach may be a valuable and more cost-efﬁcient alternative to routine reversal. Introduction There is a controversy in the literature whether neuro- muscular blocking agents should be used to facilitate endotracheal intubation in patients undergoing thyroid & Ombeline Empis de Vendin surgery and requiring intraoperative neuromonitoring of firstname.lastname@example.org the recurrent laryngeal nerve. Whilst NMBAs facilitate Denis Schmartz endotracheal intubation and
World Journal of Surgery – Springer Journals
Published: Mar 27, 2017
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