Discussions
nerve injury, paralysis
MINOR
RLN paralysis continues to be a major source of morbidity after thyroid surgery [It is well known that NMBAs can affect the movement of laryngeal muscles. However, Marusch [As shown in Fig. When TOFr was ≤ 0.85, the mean RLN or vagus nerve EMG amplitude increased with increasing TOFr. Once TOFr > 0.85, the mean EMG amplitude did not increase with the increase of TOFr. There was a significant difference in the degree of relaxation of the adductor pollicis muscle and the vocalis muscle. The laryngeal muscles exhibited a shorter response time than the adductor pollicis and recovered more quickly [When TOFr is greater than 0.75, it could reflect more than 76.47% of the effective RLN electrophysiological signals and reflect more than 52.94% of the effective Vagus nerve electrophysiological signals. When TOFr is less than 0.75, it could only reflect less than 38.64% of the effective Vagus nerve electrophysiological signals. Considering the mean EMG amplitudes and the incidence of EMG amplitudes > 500 µV in different TOFr intervals, TOFr less than 0.75 can still be appropriate for IONM, but 0.75 < TOFr ≤ 0.85 was the optimal timing for IONM during thyroid surgery. For 0.95 < TOFr ≤ 1 interval, both the mean EMG amplitude and the incidence of EMG > 500 µV were smaller than 0.75 < TOFr ≤ 0.85 interval. The reasons may be confounding factors. First, data were missed due to machine connection or probe connection problems. Second, there may be potential minor nerve injury during thyroidectomy.There is more than one method to assess laryngeal muscle function [There were several limitations to this study: Firstly, previous studies recommended a stimulator probe current intensity of 1–2 mA [