{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T03:58:19Z","timestamp":1773028699482,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T00:00:00Z","timestamp":1632528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Intraoperative neuromonitoring (IONM) is frequently used in thyroid surgery to reduce recurrent laryngeal nerve injury. The use of neuromuscular blockade agent to facilitate tracheal intubation, is a common cause of IONM failure. We performed a retrospective analysis to assess the efficacy of neostigmine\u2010glycopyrrolate as a neuromuscular blockade reversal agent for IONM during thyroid surgery. Rocuronium (0.6\u00a0mg\/kg) was administered for muscle relaxation. Neostigmine (2\u00a0mg) and glycopyrrolate (0.4\u00a0mg) were administered immediately after intubation. Cricothyroid muscle\u2010twitch response upon external branch of superior laryngeal nerve stimulation and electromyography amplitudes of vagal and recurrent laryngeal nerves before (V1, R1) and after thyroid resection (V2, R2) were recorded. Fifty patients (23 males, 27 females) were included in the analysis. The diagnoses comprised 43 papillary thyroid carcinomas and seven benign diseases. The mean time between rocuronium injection and neostigmine\u2010glycopyrrolate injection was 5.1\u2009\u00b1\u20091.2\u00a0min, and the mean time from neostigmine\u2010glycopyrrolate injection to successful cricothyroid muscle twitching upon external branch of superior laryngeal nerve stimulation was 21.0\u2009\u00b1\u20094.5\u00a0min. All patients had V1 and R1 amplitudes of more than 500\u2009\u03bcV each, with mean V1 and R1 amplitudes of 985.3\u2009\u00b1\u2009471.6\u00a0\u03bcV and 1177.2\u2009\u00b1\u2009572.7\u00a0\u03bcV, respectively. Neostigmine\u2010glycopyrrolate was effectively used as a neuromuscular blockade reversal agent for IONM in thyroid surgeries without a significant increase in bucking events. Administration of neostigmine\u2010glycopyrrolate immediately after intubation can be recommended for successful NMB reversal to facilitate IONM during thyroid surgery.<\/jats:p>","DOI":"10.1002\/kjm2.12448","type":"journal-article","created":{"date-parts":[[2021,9,25]],"date-time":"2021-09-25T17:20:40Z","timestamp":1632590440000},"page":"59-64","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Investigation of potential neuropharmacological activity of neostigmine\u2010glycopyrrolate for intraoperative neural monitoring in thyroid surgery"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8939-1735","authenticated-orcid":false,"given":"Moon Young","family":"Oh","sequence":"first","affiliation":[{"name":"Department of Surgery Seoul National University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u2010Man","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul Metropolitan Government\u2014Seoul National University Boramae Medical Center  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongwook","family":"Won","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Seoul Metropolitan Government\u2014Seoul National University Boramae Medical Center  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tzu\u2010Yen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Kaohsiung Medical University Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1052-5348","authenticated-orcid":false,"given":"Che\u2010Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Kaohsiung Medical University Hospital  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0864-6087","authenticated-orcid":false,"given":"Gianlorenzo","family":"Dionigi","sequence":"additional","affiliation":[{"name":"Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood \u201cG. 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Martino, University of Messina  Messina Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6731-3912","authenticated-orcid":false,"given":"Hoon Yub","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery KUMC Thyroid Center, Korea University Anam Hospital, Korea University College of Medicine  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyeon","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Surgery Seoul Metropolitan Government\u2014Seoul National University Boramae Medical Center  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Suk","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Nursing Seoul Metropolitan Government\u2014Seoul National University Boramae Medical Center  Seoul South Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8830-3433","authenticated-orcid":false,"given":"Young Jun","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University College of Medicine Seoul Metropolitan Government\u2014Seoul National University Boramae Medical Center, Transdisciplinary Department of Medicine &amp; 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