Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND: Intraoperative neuromonitoring (IONM) might reduce the incidence of injury to the recurrent laryngeal nerve (RLN) during thyroidectomy. Although dislocation of endotracheal tube surface electrodes can lead to false-positive IONM results (loss of signal), the risk factors for dislocation and the effects of muscle relaxants are unclear. Therefore, to identify factors that affect IONM results, we examined the frequency and risk factors for tube dislocation after cervical extension before surgery, the effect of sugammadex administration, and the correlation between IONM results and postoperative RLN palsy. METHODS: Thirty-nine patients scheduled for thyroidectomy from October 2016 to April 2017 were enrolled. All patients underwent standard IONM and pre- and postoperative laryngoscopy. Differences in patient characteristics in the tube dislocation group and non-dislocation group, and differences in amplitude during vagal stimulation before and after sugammadex administration, were assessed by the Mann-Whitney test or Fisher's exact test. RESULTS: Tube dislocation occurred in 27 patients (69%). Sterno-cricoid distance was significantly shorter in the dislocation group (n=27) than in the non-dislocation group (n=12) (43.88 [32.2-55.91] mm vs 49.46 [40.66-55.91] mm, respectively; p=0.048). Without sugammadex, amplitude during vagal stimulation was sufficient for monitoring. Nine patients had new-onset RLN palsy, which was transient in all patients. The sensitivity of IONM was 100%, the positive predictive value was 60%, and the negative predictive value was 100%. CONCLUSIONS: The present findings suggest that anesthesiologists should use video laryngoscopy to correct tube dislocation and that a rocuronium dose of 0.6 mg/kg, without sugammadex, is adequate for IONM.

DOI： 10.1272/jnms.JNMS.2019_86-408

PubMed

researchmap

Language：Japanese   Publisher：(一社)日本心臓血管麻酔学会  

冠動脈再建術を施行した92例(男66例、平均68.3歳、女26例、平均68.9歳)を対象に、周術期管理における性差の影響について検討した。術前状態はASA分類、eGFR、左室EF、合併症(糖尿病)、冠動脈責任病変、緊急症例に関して男女間に有意差はなく、術式、手術時間、カテコラミン使用、IABP使用についても有意差はなかった。術後もICU滞在日数および在院日数に有意差はなく、予後は麻酔導入後手術開始前の胸部大動脈瘤破裂による死亡が1例(男)、術後死亡が4例(男女各2例)であった。予後に有意差はなかったが、術後死亡の原因をみると、男性はいずれも感染症を契機とした多臓器不全であったのに対し、女性はそれぞれ心不全、不整脈(心房細動発症後の突然死)であり、心血管イベントの発生率で有意差を認めた。

researchmap

Other Link： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J05198&link_issn=&doc_id=20140917280004&doc_link_id=%2Fca4crbam%2F2014%2F001801%2F005%2F0021-0024%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fca4crbam%2F2014%2F001801%2F005%2F0021-0024%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Event date： 2021.9 - 2021.10

Language：Japanese   Presentation type：Poster presentation  

researchmap

Event date： 2021.9 - 2021.10

Language：Japanese   Presentation type：Poster presentation  

researchmap

Event date： 2017.11

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2016.11

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2015.10

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap