ED 50 of sugammadex for rapid recovery of signal of intraoperative neuromonitoring of recurrent laryngeal nerve in radical thyroidectomy / 中华麻醉学杂志

ABSTRACT

Objective:To determine the 50% effective dose (ED 50) of sugammadex for rapid recovery of the signal of intraoperative neuromonitoring of recurrent laryngeal nerve in radical thyroidectomy. Methods:American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of either sex, aged 18-64 yr, weighing 40-90 kg, scheduled for elective radical thyroidectomy under intraoperative neuromonitoring of recurrent laryngeal nerve, were enrolled in this study.Sufentanil and propofol were intravenously injected, and muscle relaxation monitoring was performed after the patients lost consciousness.Rocuronium 0.6 mg/kg was intravenously injected, and tracheal intubation was performed when the twitch ratio was 0.The infusion rate of rocuronium was adjusted to maintain twitch ratio 0-10%.When the signal needed to be detected, rocuronium infusion was stopped, sugammadex was injected intravenously using up-and-down sequential method, with the initial dose of 2 mg/kg.If a stable signal was detected within 3 min, the concentration decreased by 0.2 mg in the next patient, otherwise the concentration increased by 0.2 mg in the next patient.The Dixon and Massey formula was used to calculate the ED 50 and 95% confidence interval of sugammadex. Results:The ED 50 of sugammadex for the rapid recovery of the signal of intraoperative neuromonitoring of recurrent laryngeal nerve was 0.98 mg/kg, and the 95% confidence interval was 0.94-1.02 mg/kg during radical thyroidectomy. Conclusion:The ED 50 of sugammadex for rapid recovery of the signal of intraoperative neuromonitoring of recurrent laryngeal nerve is 0.98 mg/kg in radical thyroidectomy.