Effects Of Different Induction Doses Of Cisatracurium On Intraoperative Recurrent Laryngeal Nerve Monitoring In Patients With Thyroid Carcinoma Surgery

Objective:To compare the effects of different induction doses of cisatracurium on intraoperative recurrent laryngeal nerve monitoring in patients with thyroid carcinoma surgery.Methods:150 patients(ASA Ⅰ-Ⅱ)aged 30-60 years olds undergoing intraoperative recurrent laryngeal nerve monitoring were randomly divided into three groups according to the different induction doses of cisatracurium,50 cases in each group.Anesthesia induction:midazolam 0.03mg/kg,propofol 2-3mg/kg,fentanyl 3-4μg/kg,cisatracurium 0.05mg/kg(group A),0.1mg/kg(group B)and 0.15mg/kg(group C).After 3 minutes and the Narcotrend value less than 46,the recurrent laryngeal nerve monitoring tracheal tube was intubated by laryngoscope and mechanical ventilation was performed.Anesthesia maintenance was performed with propofol infusion,remifentanil infusion and sevoflurane inhalation.Record the general data of three groups of patients,such as sex ratio,age,weight and operation time;Laryngoscopy exposure classifications(Cormach-Lehane,C-L)were recorded during intubation:the cases of grade Ⅰ-Ⅳ;Record the time from intravenous cisatracurium injection to recurrent laryngeal nerve exposure(T1);Record the time from intravenous cisatracurium injection to the time of first monitoring of recurrent laryngeal nerve electrical signal(T2);The amplitude of the stimulated lateral recurrent laryngeal nerve electrical signal was measured at 40min(T3),50min(T4),60min(T5),70min(T6)after intravenous cisatracurium injection.Results:There was no statistically significant difference among the three groups in general data such as sex ratio,age,weight and operation time(P>0.05).Compared with group A,the proportion of grade Ⅱ was significantly increased(P<0.05)and the proportion of grade Ⅲ was significantly decreased(P<0.05)in group B;Compared with group A,the proportion of grade Ⅰ was significantly increased(P<0.05)and the proportion of grade Ⅲ was significantly decreased(P<0.05)in group C;Compared with group B,the proportion of grade Ⅰ was significantly increased(P<0.05)and the proportion of grade II was significantly decreased(P<0.05)in group C.Compared with group A,T2 was significantly prolonged(P<0.05),the electrical signal of T3 was none,T4 and T5 were significantly lower(P<0.05)in group C;Compared with group B,T2 was significantly prolonged(P<0.05),the electrical signal of T3 was none,T4 and T5 were significantly lower(P<0.05)in group C;The values of T1 T2 and the amplitude peak values of recurrent laryngeal nerve electrical signal at T3 to T6 were close between group A and B,the difference was not statistically significant.Conclusion:Cisatracurium 0.1mg/kg(2 times ED95)for anesthesia induction is suitable for intraoperative recurrent laryngeal nerve monitoring in patients with thyroid carcinoma surgery.