Key result
Recent thyroid surgery anesthesia advances highlight IONM, precise EMG tube positioning, and optimal NMBA use.
This review summarizes recent advances in anesthetic management for thyroid surgery, particularly focusing on intraoperative neuromonitoring and neuromuscular blockade.
Refinements in NMBA dosing and EMG tube positioning may aid IONM in thyroid surgery; leaves open standardized protocols pending prospective data.
The aim of this review is to analyze what's new on anesthetic prospective to perioperative management for thyroid surgery. For recent decades intraoperative neuromonitoring (IONM) during thyroid and parathyroid surgery has obtained more and more popularity. New modality of anesthetic technique was also developed to incorporate into surgical teamwork. For example, the precise position of EMG tube and optimal use of neuromuscular blocking agents (NMBAs) play key roles in successful IONM system. Special focus is paid to following issues: (I) preoperative airway evaluation and pre-op preparation; (II) anesthetic managements including advanced intubation tools, NMBAs and sugammadex; and (III) post-op adverse events such as pain and postoperative nausea vomiting.
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Lu et al. (2017) conducted a review in Thyroid surgery. Perioperative anesthetic management and intraoperative neuromonitoring was evaluated. Recent advances in perioperative anesthetic management for thyroid surgery highlight the importance of intraoperative neuromonitoring, precise EMG tube positioning, and optimal use of NMBAs.
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