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Objectives: In thyroid surgery, where intraoperative monitoring (IONM) of the recurrent laryngeal nerves is used, for induction in anesthesia, we usually use succinylcholine or totally avoid neuromuscular blocking agents. The aim of this study was to investigate if a full dose of rocuronium, reversed by low dose sugammadex, permits to replace the referred methods which are not totally acceptable. Methods: 75 patients were equally divided in groups A, B, C. A received rocuronium, B succinylcholine, C didn’t receive any muscle relaxant for induction. We compared intubation conditions among them. In groups A and B, we estimated the time after administration of muscle relaxation, that patients were free from muscular blockade, so that IONM could be safely used. Results: The proportion of good/excellent Intubation Condition Score was significantly greater in groups A and B, compared to C. No significant difference was found in correspondence portion, between A and B (p>0,05). In A, the time for neuromuscular junction recovery was 16, 9 ± 4, 8 min. Conclusions : Rocuronium 0,6 mg/kg, administered with remifentanil 1 mcg/kg and propofol 2,5 mg/kg, generally provides excellent or good intubation conditions. Sugammadex makes rocuronium suitable muscle relaxant for thyroid surgery, even when IONM is used.

Intraoperative Rocuronium Reversion by Low Doses of Sugammadex, in Thyroid Surgery, with Monitoring of the Recurrent Laryngeal Nerves