Comparison Between Sevoflurane and Propofol With Remifentanil Anesthesia Avoid Neuromuscular Blocking Agent After Intubation in Thyroid Operation
Abstract Background: The goal of the study is to compare sevoflurane and propofol with remifentanil anesthesia avoid neuromuscular blocking agent after intubation in thyroid operation with intra-operative neuromonitoring.Methods: 80 patients scheduled to receive thyroid operation were randomly assigned to sevofluraneor propofol anesthesia maintained group. The time of rocuronium recovery profile were monitored. Adverse events such as sinus bradycardia, tachycardia, hypertension, hypotension and movement were recorded. Analyze the time from anesthetic stop to the extubation time and operation time. Record the incidence rate of sore throat, drowsiness, agitation, nausea and vomiting after extubation. Record the first neuromonitoring time and the number of successful neuromonitoring.Results: There were significant differences in the recovery profile of rocuronium between sevoflurane and propofol group(P<0.05). The incidence of hypotension was similar between sevoflurane and propofol group. There was no significant difference of sinus braducardia between the two groups. The incidence of movement was less in sevoflurane compared to propofol(12.% vs. 47.5%, P=0.002). The propofol group had longer extubation time than sevoflurane group(13.10±1.52 vs. 8.07±1.07 min, P=0.001).The incidence of sore throat, drowsiness, agitation, nausea and vomiting in the two groups was similar during the recovery period, and the difference was not statistically significant. There was no significant difference of neuromonitoring between the two groups.Conclusion: Sevoflurane has advantage with less movement adverse effects in thyroid surgery with intra-operative neuromonitoring compared to propofol when associated with remifentanil 0.1μg/kg/min in general anesthesia.Trial registration: Chinese Clinical Trial Registry (ChiCTR1800017166, 15 July 2018)