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Objective: To explore the recurrent laryngeal nerve monitoring requirements under inhalation anesthesia to reduce muscle relaxant vecuronium dose is feasible. Methods: ASA classification (American Society of Anesthesiologists physical status classification of patients)Ⅰ~Ⅱlevels in patients scheduled for thyroid surgery 80 cases (with neuromuscular disease and myasthenia syndrome excluded), all patients were informed prior to surgery may conduct the monitoring, this study has been made in the hospital Ethics Commission agreed that the patients before surgery to obtain informed consent, were randomly divided into two groups: conventional dosage of vecuronium group (Ⅰgroup); reduction of vecuronium group (Ⅱgroup)The group carried out operations in patients with recurrent laryngeal nerve monitoring; vecuronium conventional treatment group (Ⅰgroup) were 40, 9 males, 31 females, the induction of anesthesia to midazolam 0.03mg/kg, propofol 1.0mg/kg, sufentanil 0.35μg/kg, vecuronium 0.1mg/kg, nitrogen and oxygen masks to manual ventilation after 3 minutes to complete tracheal intubation, patients inhaled NO2︰ O2 = 1︰ 1 , sevoflurane 1% to 2% to maintain depth of anesthesia during the operation to recover under the circumstances Garvey rocuronium 0.02 mg / kg, the appropriate additional analgesic sufentanil 0.1μg/kg. Vecuronium bromide reduction group (Ⅱgroup) were 40, male 7, female 33, for the induction of anesthesia with midazolam 0.06mg /kg, propofol 1.5mg/kg, sufentanil 0.6μg/kg, vecuronium 0.05mg/kg. Inhaled oxygen nitrogen discharge masks to manual ventilation after 3 minutes to complete tracheal intubation, patients inhaled NO2:O2 = 1 :1,2% to 3% halothane to maintain depth of anesthesia, surgery is no longer chasing Garvey rocuronium. Intraoperative fentanyl 0.1μg/kg recovery Jiashu spontaneous breathing the case affects the operation 1mg/kg of intravenous propofol to deepen anesthesia, inhibition of spontaneous breathing. Surgery patients with continuous monitoring of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), oxygen saturation (SPO2), EEG spectral frequency index (BIS),Selected before induction of anesthesia (t1), after intubation (t2), half an hour after the beginning of surgery (t3), 1 hour after the beginning of surgery (t4), the midpoint of the whole operation time (t5), surgery before the end of 1 hour (t6 ), half an hour before the end of surgery (t7) at each time point of blood pressure and heart rate were compared between groups to assess the different anesthetic drugs in patients with blood pressure and heart rate under the program of the volatility of the difference. At the same time each time point compared bispectral index, evaluation of two anesthetic regimen on patient safety. Results:Two groups of induction of anesthesia and surgery in patients with stable vital signs, adequate depth of anesthesia, surgery and return to the wards after the end of postoperative agitation, nausea and vomiting were lower than 1.5%. Muscle relaxant vecuronium bromide reduction group to ensure the smooth progress of the recurrent laryngeal nerve monitoring. Patients in both groups re-occur without intraoperative awareness. Conclusion: Combined intravenous anesthesia used in the dose of vecuronium to meet the requirements of the recurrent laryngeal nerve monitoring, feasibility. Do not ask for muscle relaxation during surgery, the modest reduction of muscle relaxant vecuronium may reduce the muscle relaxant for significant residual effect.
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