Lidocaine And Neuromonitoring in Thyroid Surgery

  • End date
    Dec 1, 2024
  • participants needed
  • sponsor
    Saint Petersburg State University, Russia
Updated on 7 October 2022


The aim of this study is to test the hypothesis that the quality of recovery with topical lidocaine is better than placebo.


The use of neuromonitoring in thyroid surgery imposes a number of special demands for anaesthetic management. Such demands include avoiding muscle relaxation and local anaesthesia. Maintaining a balance between the risk of awakening during surgery and excessively deep anaesthesia in fast track surgery is an important task for the anaesthesiologist.

Mild anaesthesia in the absence of muscle relaxation increases the risk of developing laryngeal reflexes, coughing during surgery, while excessively deep anaesthesia slows down recovery after surgery and increases the risk of arterial hypotension. The frequency and duration of arterial hypotension, as well as the depth of anesthesia assessed by the Bispectral index, are independent risk factors for postoperative cardiovascular complications and long-term mortality. On the other hand, coughing in response to irritation of the endotracheal tube during recovery from anesthesia is recognized as a risk factor for respiratory and cardiovascular complications, as well as postoperative wound insufficiency.

Optimization the anesthesia by intravenous infusion of lidocaine can improve anesthesia controllability, hemodynamic stability and overall anesthesia recovery rates. Local use of lidocaine, including filling the endotracheal tube cuff with its alkalinized solution, has also been shown to be effective in reducing the frequency of laryngeal reflexes upon awakening after surgery of varying duration. However, the efficacy and safety of local use of lidocaine under neuromonitoring conditions has not been studied. Despite recommendations to avoid the local use of lidocaine for tracheal intubation, there is evidence of the safety of this technique in the absence of a negative impact on the quality of neuromonitoring.

The purpose of this study is to test the hypothesis that the quality of recovery with topical lidocaine is better than placebo. At the same time, the investigators assume that recovery after surgery will be comparable with both local and intravenous use. Intergroup differences in arterial hypotension, depth of anesthesia and intraoperative neuromonitoring parameters will also be investigated.

Condition Thyroid Neoplasm, Parathyroid Neoplasms, Anesthesia
Treatment intravenous placebo, Intravenous Lidocaine, Intra-cuff lidocaine, Intra-cuff placebo
Clinical Study IdentifierNCT04574947
SponsorSaint Petersburg State University, Russia
Last Modified on7 October 2022


Yes No Not Sure

Inclusion Criteria

Planned thyroid surgery
Age> 45 years
Signed informed consent to participate in the study

Exclusion Criteria

Emergency surgery
Redo surgery
Contraindications for lidocaine use
Enrolment to another randomised clinical trial within the last 30 days
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