比较甲状腺手术术中神经监测中苏伽达格的剂量：一项随机对照试验。
Comparison of Sugammadex Dose for Intraoperative Neuromonitoring in Thyroid Surgery: A Randomized Controlled Trial.
机构信息
Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
出版信息
Laryngoscope. 2021 Sep;131(9):2154-2159. doi: 10.1002/lary.29515. Epub 2021 Mar 15.
OBJECTIVES/HYPOTHESIS: To compare effect of 1 and 2 mg/kg of sugammadex on the incidence of intraoperative bucking and intraoperative neuromonitoring (IONM) quality in thyroid surgery.
STUDY DESIGN
Randomized controlled trial.
METHODS
Patients qualified for thyroid surgery with IONM were eligible for this double-blind, randomized, controlled trial. After tracheal intubation with 0.6 mg/kg rocuronium, 1 or 2 mg/kg of sugammadex was administered to patients in group I or II, respectively. The quality of the IONM for the external branch of the superior laryngeal nerve (EBSLN) was evaluated (strong/intermediate/weak). The initial amplitude of electromyography for the vagus nerve (V1) and the recurrent laryngeal nerve (R1) were recorded. Intraoperative bucking movements was recorded.
RESULTS
A total of 102 patients (51 in each group) completed the study. Time from sugammadex administration to initial checking for the EBSLN was not different between group I and II (25.0 ± 7.9 vs. 25.5 ± 9.0 minutes, P = .788). There was no difference in the neuromonitoring quality for the EBSLN between group I and II (strong/intermediate/weak: 46/5/0 vs. 50/1/0, P = .205). The amplitudes of V1 (1,086.3 ± 673.3 μV vs. 1,161.8 ± 727.5 μV, P = .588) and R1 (1,328.2 ± 934.1 μV vs. 1,410.5 ± 919.6 μV, P = .655) were comparable between the groups. Patients who experienced bucking were significantly fewer in the group I than the group II (13.7% vs. 35.3%, P = .020).
CONCLUSION
A dose of 1 mg/kg sugammadex induced less bucking than 2 m/kg while providing comparable IONM quality during thyroid surgery.
LEVEL OF EVIDENCE
2 Laryngoscope, 131:2154-2159, 2021.
目的/假设：比较 1mg/kg 和 2mg/kg 琥珀酸舒更葡糖钠对甲状腺手术中术中扭动和术中神经监测（IONM）质量的影响。
研究设计
随机对照试验。
方法
符合 IONM 下甲状腺手术条件的患者有资格参加这项双盲、随机、对照试验。患者在给予 0.6mg/kg 罗库溴铵后进行气管插管，分别给予 I 组或 II 组 1mg/kg 或 2mg/kg 琥珀酸舒更葡糖钠。评估喉上神经外支（EBSLN）的 IONM 质量（强/中/弱）。记录迷走神经（V1）和喉返神经（R1）的初始肌电图幅度。记录术中扭动运动。
结果
共有 102 名患者（每组 51 名）完成了研究。I 组和 II 组之间从琥珀酸舒更葡糖钠给药到首次检查 EBSLN 的时间无差异（25.0±7.9 分钟 vs. 25.5±9.0 分钟，P=0.788）。I 组和 II 组之间 EBSLN 的神经监测质量无差异（强/中/弱：46/5/0 与 50/1/0，P=0.205）。V1 的幅度（1,086.3±673.3μV 与 1,161.8±727.5μV，P=0.588）和 R1 的幅度（1,328.2±934.1μV 与 1,410.5±919.6μV，P=0.655）在两组之间相似。扭动的患者在 I 组明显少于 II 组（13.7%与 35.3%，P=0.020）。
结论
1mg/kg 琥珀酸舒更葡糖钠的剂量引起的扭动比 2mg/kg 少，而在甲状腺手术期间提供可比的 IONM 质量。
证据水平
2 喉科学，131：2154-2159，2021。
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