神經監測甲狀腺手術之麻醉考量

近十多年來，神經監測甲狀腺和副甲狀腺手術越來越普及。神經監測手術團隊合作，導入改良的麻醉技術形式。其中最重要的兩個麻醉考慮分別是肌電圖氣管內管的準確位置和肌肉鬆弛劑的適當使用。另外需要注意以下議題：(1) 術前氣道評估和術前準備；(2) 麻醉處置，包括影像插管系統，肌肉鬆弛劑和環糊精  (sugammadex)之搭配；(3) 術後合併症處理，例如疼痛和術後噁心嘔吐

Neural Monitoring During Thyroid Surgery-anesthesia Perspective 

In recent decades intraoperative neural monitoring (IONM) during thyroid and parathyroid surgery has obtained more and more popularity. New modality of anesthetic technique was also developed to incorporate into surgical teamwork. The most two important anesthetic considerations are precise position of the EMG tube and optimal use of neuromuscular blocking agents (NMBAs). Special focus is paid to following issues: (I) preoperative airway evaluation and pre-op preparation; (II) anesthetic managements including advanced intubation tools, NMBAs and sugammadex; and (III) post-op adverse events such as pain and postoperative nausea vomiting.