Lidocaine Reduces Muscle Tremor is Beneficial for Intraoperative Recurrent Laryngeal Nerve Monitoring

Bo Wang,MD

Status: Unknown

Conditions: Thyroid Cancer; Accessory Nerve Injuries; Neck Cancer; Recurrent Laryngeal Nerve Injuries; EMG: Repetitive Nerve Stimulation Abnormality

Treatments: Drug: Lidocaine

Study type: Interventional

Funder types: Other

Identifiers

NCT03530033

BND IONM Lidocaine

Details and patient eligibility

About

In recent years, the application of intraoperative recurrent laryngeal nerve monitoring in thyroid surgery has greatly reduced the complications of recurrent laryngeal nerve injury. The use of intraoperative neurological monitoring requires the reduction of the dose of neuromuscular blockade, which often leads to muscle tremors during the application of electrical energy, which affects the fine separation around the muscles. This study explored the effect of local application of lidocaine on reducing muscle tremor during surgery and its optimal dose.

Full description

According to the random number method, eligible patients were randomly divided into 2 groups. Group A was the conventional surgery group, and Group B was the lidocaine group. The operative time for the separation of the sternocleidomastoid muscle from the two groups of patients was analyzed, as well as the length of time for the search for the accessory nerve and the effect of intraoperative nerve monitoring on the EMG signal.

Enrollment: 40 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Thyroid papillary carcinoma
• Lateral cervical lymph node metastasis
• The diameter of the metastatic lymph nodes is less than 3cm
• Without internal jugular vein invasion

Exclusion criteria

• Lidocaine allergy sufferers

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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40 participants in 2 patient groups

Conventional surgery group

No Intervention group

Description:

Induction of anesthesia according to conventional neuromuscular blockade dose, no neuromuscular blockade drug maintenance during lateral neck dissection.

Lidocaine group

Experimental group

Description:

Anesthesia induction was performed according to conventional nerve monitoring neuromuscular blockade doses and lateral neck dissection was performed. When local muscle tremors occur, lidocaine is injected locally to eliminate muscle tremors.

Treatment:

Drug: Lidocaine