Lidocaine Reduces Muscle Tremor is Beneficial for Intraoperative Recurrent Laryngeal Nerve Monitoring

Study Overview
=================
Brief Summary
-----------------
In recent years, the application of intraoperative recurrent laryngeal nerve monitoring in thyroid surgery has greatly reduced the complications of recurrent laryngeal nerve injury. The use of intraoperative neurological monitoring requires the reduction of the dose of neuromuscular blockade, which often leads to muscle tremors during the application of electrical energy, which affects the fine separation around the muscles. This study explored the effect of local application of lidocaine on reducing muscle tremor during surgery and its optimal dose.

Detailed Description
-----------------
According to the random number method, eligible patients were randomly divided into 2 groups. Group A was the conventional surgery group, and Group B was the lidocaine group. The operative time for the separation of the sternocleidomastoid muscle from the two groups of patients was analyzed, as well as the length of time for the search for the accessory nerve and the effect of intraoperative nerve monitoring on the EMG signal.

Official Title
-----------------
Lidocaine Reduces Muscle Tremor Caused by Electric Energy Devices, Which is Beneficial for Intraoperative Recurrent Laryngeal Nerve Monitoring During Endoscopic Thyroid Lateral Neck Dissection

Conditions
-----------------
Thyroid Cancer, Neck Cancer, Recurrent Laryngeal Nerve Injuries, Accessory Nerve Injuries, EMG: Repetitive Nerve Stimulation Abnormality

Intervention / Treatment
-----------------
* Drug: Lidocaine


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Thyroid papillary carcinoma Lateral cervical lymph node metastasis The diameter of the metastatic lymph nodes is less than 3cm Without internal jugular vein invasion Exclusion Criteria: Lidocaine allergy sufferers

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Conventional surgery group<br>Induction of anesthesia according to conventional neuromuscular blockade dose, no neuromuscular blockade drug maintenance during lateral neck dissection. | |
| Experimental: Lidocaine group<br>Anesthesia induction was performed according to conventional nerve monitoring neuromuscular blockade doses and lateral neck dissection was performed. When local muscle tremors occur, lidocaine is injected locally to eliminate muscle tremors. | Drug: Lidocaine<br>* Local injection of lidocaine reduces muscle tremor<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| dose of muscle relaxant drugs | dose of muscle relaxant drugs | At the end of surgery | 
| dose of lidocaine | dose of lidocaine | At the end of surgery | 
| Number of nerve signal loss cases | Number of nerve signal loss cases | At the end of surgery | 
| Anatomical time of accessory nerve | Anatomical time of accessory nerve | At the end of surgery | 
| The satisfaction of sternocleidomastoid muscle separation | The visual score was 5 points for the most satisfaction and 0 points for the most dissatisfied. | At the end of surgery |