For successful intraoperative neuromonitoring (IONM), adequate reversal of neuromuscular blocking agent is a prerequisite in thyroid surgery with . The aim of this study is to investigate the feasibility of neostigmine just after tracheal intubation on the IONM in thyroid surgery.
For successful intraoperative neuromonitoring (IONM), adequate reversal of neuromuscular blocking agent is a prerequisite in thyroid surgery with . The aim of this study is to investigate the feasibility of neostigmine just after tracheal intubation on the IONM in thyroid surgery. This study will be performed as a randomized controlled trial with two groups (N group: neostigmine group and NS group: normal saline group). For the N group, neostigmine (0.03 mcg / kg) and glycopyrrolate with a 5:1 ratio will be administered just after tracheal intubation. For the NS group, normal saline with a same volume of the N group will be administered just after tracheal intubation. For all patients of two groups, investigators evaluate the quality of signal of IONM during the surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
44
For the N group, neostigmine (0.03 mcg / kg) and glycopyrrolate with a 5:1 ratio will be administered just after tracheal intubation. Investigators evaluate the quality of signal of IONM during the surgery.
For the NS group, neostigmine normal saline (0.09 cc/kg; the same volume of the group N) will be administered just after tracheal intubation. Investigators evaluate the quality of signal of IONM during the surgery.
Seoul Metropolitan Government Seoul National University Boramae Medical Center
Seoul, South Korea
Time to recovery of cricothyroid muscle twitching
Time from the rocuronium administration to recovery of cricothyroid muscle twitching
Time frame: perioperative
amplitude of EMG for V1
micro-volts (uV), Electromyography amplitude of the vagus nerve before tumor manipulation
Time frame: During surgery
amplitude of EMG for R1
micro-volts (uV), Electromyography amplitude of the recurrent laryngeal nerve before tumor manipulation
Time frame: During surgery
amplitude of EMG for R2
micro-volts (uV), Electromyography amplitude of the recurrent laryngeal nerve after tumor removal
Time frame: During surgery
amplitude of EMG for V2
micro-volts (uV), Electromyography amplitude of the vagus nerve after tumor removal
Time frame: During surgery
number of patients with involuntary movements disrupting surgery
number, number of patients who move involuntarily during surgery, which disrupt and pause the surgery to prevent harmful events, such as tracheal injuries by a sharp surgical devices during the surgery
Time frame: During surgery
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