title: Recurrent Laryngeal Nerve Monitoring and Rocuronium: A Selective Sugammadex Reversal Protocol.
abstract: The use of neuromuscular blocking agents may affect intraoperative neuromonitoring during thyroid surgery. A selective neuromuscular recovery protocol was evaluated in a retrospective cohort study during human thyroid neural monitoring surgery.
  
  
  
  One hundred and twenty-five consecutive patients undergoing thyroidectomy with intraoperative neuromonitoring followed a selective neuromuscular block recovery protocol-single intubating dose of rocuronium followed by sugammadex if needed at the first vagal stimulation (V1).
  
  
  
  Data from 120 of 125 patients could be analysed. Fifteen (12.5%) patients needed sugammadex reversal to obtain an EMG response at the first vagal stimulation (V1). In the remaining 105 patients, spontaneous recovery of rocuronium-induced neuromuscular block was sufficient for a successful first vagal stimulation (V1).
  
  
  
  In patients undergoing thyroid surgery, routine reversal of rocuronium block with sugammadex is not mandatory for reliable intraoperative neuromonitoring. A selective neuromuscular block recovery approach may be a valuable and more cost-efficient alternative to routine reversal.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, CHRU de Nancy, Vandoeuvre-lès-Nancy, France. ombelineempisdevendin@hotmail.fr.|Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France. ombelineempisdevendin@hotmail.fr.
authors.forename: Ombeline
authors.initials: O
authors.lastname: Empis de Vendin
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, CHRU de Nancy, Vandoeuvre-lès-Nancy, France.|Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Schmartz
authors.affiliation: Department of Digestive, Hepato-Biliary and Endocrine Surgery, CHRU de Nancy, Vandoeuvre-lès-Nancy, France.|Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, CHRU de Nancy, Vandoeuvre-lès-Nancy, France.|Faculté de Médecine, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fuchs-Buder
mesh_terms: D000328:Adult; D000368:Aged; D000732:Androstanols; D000931:Antidotes / Q000627:therapeutic use*; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents; D020127:Recovery of Function / Q000187:drug effects; D012009:Recurrent Laryngeal Nerve / Q000503:physiopathology*; D012189:Retrospective Studies; D000077123:Rocuronium; D000077122:Sugammadex; D013965:Thyroidectomy; D047408:gamma-Cyclodextrins / Q000627:therapeutic use*
chemical_list: D000732:Androstanols; D000931:Antidotes; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium