Skip to main content

Advertisement

SpringerLink
Log in

Dosage Effect of Rocuronium on Intraoperative Neuromonitoring in Patients Undergoing Thyroid Surgery

  • Original Paper
  • Published:
Cell Biochemistry and Biophysics Aims and scope Submit manuscript

Abstract

The effect of different concentrations of rocuronium bromide used for anesthesia induction during thyroid surgery on the intraoperative recurrent laryngeal nerve monitoring was evaluated. One hundred patients undergoing thyroid operation were randomized into five groups (20 patients per group). Patients in group I were operated and monitored without the use of rocuronium bromide. Patients in groups II–V were respectively injected with 0.5x, 1x, 1.5x, and 2x ED95 rocuronium bromide intravenously. The time from injecting the rocuronium bromide to the beginning of tube insertion was recorded, the conditions of tracheal intubation were evaluated, and the changes in blood pressure and pulse during the intubation process were monitored. Vagus nerve/recurrent laryngeal nerve evoked muscle potential was monitored using the NIM-Response3.0 nerve electromyography monitor. The amplitude of electromyography signal was recorded every 5 min during 30 min after successful tracheal intubation. The tracheal intubation success rate was 100 % in all groups. Compared with group I, intubating condition scores (Cooper scores) in the patients of groups II–V were higher (P < 0.05). The stability of intraoperative neuromonitoring signal amplitude in groups I–III met the monitoring standards. The findings suggest that the use of 0.5x or 1x ED95 rocuronium bromide during the anesthesia induction can improve the tracheal tube conditions without affecting the intraoperative recurrent laryngeal nerve monitoring. The use of 1x ED95 rocuronium bromide induction was associated with the best results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Minahan, R. E. (2002). Intraoperative neuromonitoring. Neurologist, 8(4), 209–226.

    Article  PubMed  Google Scholar 

  2. Chu, K. S., Tsai, C. J., Lu, I. C., et al. (2010). Influence of nondepolarizing muscle relaxants on intraoperative neuromonitoring during thyroid surgery. J Otolaryngol Head Neck Surg, 39(4), 397–402.

    PubMed  Google Scholar 

  3. Sloan, T. B. (2013). Muscle relaxant use during intraoperative neurophysiologic monitoring. Journal of Clinical Monitoring and Computing, 27(1), 35–46.

    Article  PubMed  Google Scholar 

  4. Peng, C., Feng, L., Zhengbo, S., et al. (2012). Effect of 1x ED95 rocuronium on IONM mentoring for patients with thyroid surgery. Chinese Journal of Anesthesiology, 05, 525–527.

    Google Scholar 

  5. Christou, N., & Mathonnet, M. (2013). Complications after total thyroidectomy. J Visc Surg, 150(4), 249–256.

    Article  CAS  PubMed  Google Scholar 

  6. Dionigi, G., Bacuzzi, A., Boni, L., et al. (2010). The technique of intraoperative neuromonitoring in thyroid surgery. Surg Technol Int, 19, 25–37.

    PubMed  Google Scholar 

  7. Lee, C., & Stack, B. C, Jr. (2011). Intraoperative neuromonitoring during thyroidectomy. Expert Review of Anticancer Therapy, 11(9), 1417–1427.

    Article  PubMed  Google Scholar 

  8. Barczyński, M., Randolph, G. W., Cernea, C. R., et al. (2013). External branch of the superior laryngeal nerve monitoring during thyroid and parathyroid surgery: International Neural Monitoring Study Group standards guideline statement. Laryngoscope, 123(Suppl 4), S1–S14.

    Article  PubMed  Google Scholar 

  9. Domosławski, P., Lukieńczuk, T., Kaliszewski, K., et al. (2013). Safety and current achievements in thyroid surgery with neuromonitoring. Adv Clin Exp Med, 22(1), 125–130.

    PubMed  Google Scholar 

  10. Hayward, N. J., Grodski, S., Yeung, M., et al. (2013). Recurrent laryngeal nerve injury in thyroid surgery: a review. ANZ J Surg, 83(1–2), 15–21.

    Article  PubMed  Google Scholar 

  11. Hui, S., Xiaoli, L., Yantao, F., et al. (2010). Application of IONM in complicated thyroid surgery. Chinese Journal of Practical Surgery, 30(1), 66–68.

    Google Scholar 

  12. Xiuli, M., Jun, W., & Liping, Z. (2006). The effect of atracurium on facial nerve monitoring in ear surgery. Chinese Journal of Minimally Invasive Surgery, 02, 137–141.

    Google Scholar 

  13. Higgins, T. S., Gupta, R., Ketcham, A. S., et al. (2011). Recurrent laryngeal nerve monitoring versus identification alone on post-thyroidectomy true vocal fold palsy: a meta-analysis. Laryngoscope, 121(5), 1009–1017.

    Article  PubMed  Google Scholar 

  14. Cernea, C. R., Brandão, L. G., & Brandão, J. (2012). Neuromonitoring in thyroid surgery. Curr Opin Otolaryngol Head Neck Surg, 20(2), 125–129.

    Article  PubMed  Google Scholar 

  15. Sanabria, A., Silver, C. E., Suárez, C., et al. (2013). Neuromonitoring of the laryngeal nerves in thyroid surgery: a critical appraisal of the literature. European Archives of Oto-Rhino-Laryngology, 270(9), 2383–2395.

    Article  PubMed  Google Scholar 

  16. Pisanu, A., Porceddu, G., Podda, M., et al. (2014). Systematic review with meta-analysis of studies comparing intraoperative neuromonitoring of recurrent laryngeal nerves versus visualization alone during thyroidectomy. Journal of Surgical Research, 188(1), 152–161.

    Article  PubMed  Google Scholar 

  17. Chu, K. S., Wu, S. H., Lu, I. C., et al. (2009). Feasibility of intraoperative neuromonitoring during thyroid surgery after administration of nondepolarizing neuromuscular blocking agents. World Journal of Surgery, 33(7), 1408–1413.

    Article  PubMed  Google Scholar 

  18. Lu, I. C., Tsai, C. J., Wu, C. W., et al. (2011). A comparative study between 1 and 2 effective doses of rocuronium for intraoperative neuromonitoring during thyroid surgery. Surgery, 149(4), 543–548.

    Article  PubMed  Google Scholar 

  19. Marusch, F., Hussock, J., Haring, G., et al. (2005). Influence of muscle relaxation on neuromonitoring of the recurrent laryngeal nerve during thyroid surgery. British Journal of Anaesthesia, 94(5), 596–600.

    Article  CAS  PubMed  Google Scholar 

  20. Hemmerling, T. M., Schmidt, J., Hanusa, C., et al. (2000). Simultaneous determination of neuromuscular block at the larynx, diaphragm, adductor pollicis, orbicularis oculi and corrugator supercilii muscles. British Journal of Anaesthesia, 85(6), 856–860.

    Article  CAS  PubMed  Google Scholar 

  21. Hemmerling, T. M., & Donati, F. (2003). Neuromuscular blockade at the larynx, the diaphragm and the corrugator supercilii muscle: a review. Canadian Journal of Anaesthesia, 50(8), 779–794.

    Article  PubMed  Google Scholar 

  22. Plaud, B., Debenb, B., Lequeau, F., et al. (1999). Mivacurium neuromuscular block at the adductor muscles of the larynx and adductor pollicis in humans. Anesthesiology, 85(1), 77–81.

    Article  Google Scholar 

  23. Sharpe, M. D., Moote, C. A., Lam, A. M., et al. (1991). Comparison of integrated evoked EMG between the hypothenar and facial muscle groups following atracurium and vecuronium administration. Canadian Journal of Anaesthesia, 38(3), 318–323.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by projects of society development plan from Changchun Science and Technology Division (12SF53) and the key support projects of science and technology from Jilin Provincial Science and Technology Department (20130206038SF).

Author information

Authors and Affiliations

  1. Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Changchun, 130033, China

    Yang-dong Han, Feng Liang & Peng Chen

Authors
  1. Yang-dong Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Feng Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peng Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peng Chen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Han, Yd., Liang, F. & Chen, P. Dosage Effect of Rocuronium on Intraoperative Neuromonitoring in Patients Undergoing Thyroid Surgery. Cell Biochem Biophys 71, 143–146 (2015). https://doi.org/10.1007/s12013-014-0176-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12013-014-0176-1

Keywords

Search

Navigation