Key result
A review of the literature identified five neuromuscular blocking agent regimens to optimize intraoperative neural monitoring quality and prevent false interpretations during thyroid surgery.
Why the study?
The proper management of neuromuscular blockade during intraoperative neural monitoring (IONM) has evolved, but misuse of neuromuscular blocking agents is associated with false IONM interpretations to surgeons.
Does proper neuromuscular blockade management optimize intraoperative neural monitoring quality in patients undergoing thyroid surgery?
Does proper neuromuscular blockade management optimize intraoperative neural monitoring quality in patients undergoing thyroid surgery?
Answers are grounded in this paper and cite their sources.
A detailed understanding of neuromuscular blocking agents and their reversal by sugammadex is crucial to optimize intraoperative neural monitoring quality during thyroid surgery.
This article reviews the literature on development of neuromuscular blockade management in thyroid surgery with intraoperative neural monitoring (IONM) in the past decade. Neuromuscular blockade management includes the choice of neuromuscular blocking agents (NMBAs) and reversal of neuromuscular blockade by sugammadex. A series of animal study and clinical trials showed NMBAs effect on IONM in thyroid surgery. We summarized five NMBA regimens for IONM: (a) relaxant-free regimen, (b) depolarizing NMBA-succinylcholine, (c) titration of nondepolarizing NMBA, and (d) rocuronium combined with sugammadex. The proper management of neuromuscular blockade during IONM has greatly developed over the past decade. The misuse of NMBAs is associated with false IONM interpretations to surgeons. A detailed understanding of NMBAs and neuromuscular blockade management by sugammadex may optimize IONM quality in patients receiving monitored thyroid surgery.
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Lu et al. (2019) conducted a review in Thyroid surgery with intraoperative neural monitoring. Neuromuscular blockade management (NMBAs and sugammadex) was evaluated. A review of the literature identified five neuromuscular blocking agent regimens to optimize intraoperative neural monitoring quality and prevent false interpretations during thyroid surgery.
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