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Effects of Deep Neuromuscular Block during Robot-Assisted Transaxillary Thyroidectomy: A Randomized Controlled Trial
Myung Il Bae1, Sang-Wook Kang2, Jong Seok Lee1
1Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Journal of Clinical Medicine
|June 10, 2023
Summary
Deep neuromuscular block significantly reduces postoperative pain following robot-assisted transaxillary thyroidectomy. This approach, however, did not show a significant effect on reducing paresthesia or sensory changes after the surgery.
Area of Science:
- Anesthesiology
- Surgical Innovation
Background:
- Robot-assisted transaxillary thyroidectomy is associated with significant postoperative pain and paresthesia.
- Chronic symptoms can persist for months, impacting patient recovery.
Purpose of the Study:
- To investigate the impact of deep neuromuscular block on postoperative pain and sensory changes after robot-assisted transaxillary thyroidectomy.
- To compare outcomes between moderate and deep neuromuscular block strategies.
Main Methods:
- A single-blinded, prospective, randomized controlled trial involving 88 patients undergoing robot-assisted transaxillary thyroidectomy.
- Patients were randomized into moderate or deep neuromuscular block groups.
- Postoperative pain, paresthesia, and sensory changes were assessed using numeric rating scales.
Main Results:
- Significant intergroup differences in pain scores over time were observed in the chest, neck, and axilla.
- The deep neuromuscular block group exhibited significantly lower pain scores on postoperative day one compared to the moderate block group (adjusted p < 0.001).
- No significant reduction in paresthesia or hypoesthesia was demonstrated with deep neuromuscular block.
Conclusions:
- Deep neuromuscular block is effective in reducing immediate postoperative pain after robot-assisted transaxillary thyroidectomy.
- Further research is needed to address persistent sensory changes and paresthesia following this surgical approach.
