Abstract:Objective To investigate the effects of droperidol combined with twice the 95% effective dose (ED₉₅) of rocuronium (0.6 mg/kg) on electromyography (EMG), intraoperative nerve monitoring (IONM), and vital sign indicators in patients during thyroid surgery. Methods A total of 100 patients undergoing scheduled thyroid surgery at Zhangjiagang First People’s Hospital between January 2023 and December 2024 were selected as the study subjects. According to the random number table method, the patients were divided into a control group and a combination group, with 50 patients in each group. The control group received rocuronium (0.6 mg/kg), while the combination group received rocuronium (0.6 mg/kg) plus droperidol (2 mg). The tracheal intubation conditions (Cooper’s score), IONM signals, vital sign indicators, EMG amplitude and neural monitoring situation, surgeon satisfaction, respiratory complications, and antagonism were compared between the two groups. Results The Cooper’s score of the patients in the combination group was higher than that in the control group (8.95 ± 0.95 vs 5.32 ± 0.54, t=23.489, P<0.01). Compared with the control group, the combination group exhibited higher maximum [ (758.90±8.59) μV vs (442.53± 9.60) μV, t=173.658, P<0.01]and minimum [ (544.06 ± 4.51) μV vs (394.64 ± 4.59) μV, t=164.191, P<0.01] amplitude values in IONM signals. In comparison with the control group, the combination group had lower propofol maintenance dosage, remifentanil maintenance dosage, proportion of cases with delayed recurrent laryngeal nerve detection, and waiting time required for delayed detection cases, with the differences being statistically significant (P< 0.05). At 60, 90, and 120 minutes, the EMG amplitude gradually increased in both groups, and the EMG amplitude of the combination group at each time point was lower than that of the control group (P<0.05). Compared with the control group after intubation, the combination group showed lower heart rate and blood pressure levels (P<0.05). Before and after anesthesia induction, there was no statistically significant differences in end-tidal carbon dioxide partial pressure (PetCO2), peak airway pressure, or saturation of peripheral oxygen (SpO2) levels between the two groups (P>0.05). There was no statistically significant difference between the two groups in the incidence of intraoperative body movement, respiratory complications, or antagonism (P>0.05). And there was no statistically significant difference in surgeon satisfaction between the two groups (P>0.05). Conclusion The combination of droperidol with twice the ED₉₅ of rocuronium can effectively improve the accuracy of IONM in thyroid surgery and help maintain the stability of vital sign indicators of patients.