Different Doses Of Mivacurium For Anesthesia Induction On The Effect Of Signal In Patients Undergoing Thyroid Surgery Under Neural Monitoring

Objective:To evaluate the effection of different doses mivacurium useing in anesthesia induction on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods:Selection of one hundred and twenty patients who undergoing thyroid surgery,aged 20-64 yr,weighing 50-85 kg,ASAⅠorⅡ,for general anesthesia,were randomly divided into four groups: groupⅠ(n=30),groupⅡ(n=30)and groupⅢ(n=30),grou IV(n=30).30 mins before operation,each patient was injected with penehyclidine hydrochloride 1mg by intramuscular.Anesthesia induction was midazolam 2 mg,propofol 2mg/kg,sulfentanil 0.4μg/kg.When BIS value was 40-50,patients in group I inhaled sevoflurane,waiting for the end-tidal sevoflurane concentration of 4%.After 10 s,the electromyographic(EMG)endotracheal tube was inserted.Group II intravenous injection of mivacurium 0.07mg/kg;III group intravenous injection of mivacurium 0.10mg/kg,IV group were intravenous injection of mivacurium 0.14mg/kg,and the electromyographic(EMG)endotracheal tube was intubated under glidescope at 3 min after mivacurium administration.The tube was fixed on one side of the mouth,confirmed the depth of the catheter.Started mechanical ventilation.Anesthesia was maintained with inhalation of sevoflurane in four groups,MAC1.2-1.4.Recorded the blood pressure and heart rate at 3min after induction,1min after intubation,intubation,after induction,before induction.Cooper’s scores were recorded.30 min after induction of anesthesia,the recurrent laryngeal nerve-evoked IONM response was monitored every 5 min,7 times were collected.Results:Tracheal intubation was performed successfully in all cases,but tracheal intubation in group III and group IV was significantly better than that in group I and II(P<0.05),and no obvious circulatory fluctuation was observed during tracheal intubation.There was no significant difference between group I and group II(P > 0.05),and there was no significant difference between groups III in group IV(P > 0.05).Compared with group I and group II,although the IONM amplitude in III group decreased at different time points(P<0.05),but meet the monitoring requirements.There were no IONM amplitude in group IV within 30 min after anesthesia induction.The IONM was obtained after 40 min,but the value was too low.Conclusion : 0.10mg/kg mivacurium may be helpful to provide satisfactory intubation conditions,no causing blood pressure and heart rate changed,intraoperative nerve monitoring signal and measured to determine whether there is a guiding significance of recurrent laryngeal nerve injury,is suitable for induction of anesthesia in the surgery Operation.