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Effects of deep vs moderate neuromuscular block on the quality of recovery after robotic gastrectomy

Authors
 Hyun J. Kim  ;  Ki‐Young Lee  ;  Myoung H. Kim  ;  Hyoung‐Il Kim  ;  Sun J. Bai 
Citation
 ACTA ANAESTHESIOLOGICA SCANDINAVICA, Vol.63(3) : 306-313, 2019 
Journal Title
 ACTA ANAESTHESIOLOGICA SCANDINAVICA 
ISSN
 0001-5172 
Issue Date
2019
Keywords
gastrectomy ; neuromuscular blockade ; neuromuscular monitoring ; randomized controlled trial ; robotic surgery
Abstract
BACKGROUND: It remains unclear whether deep neuromuscular blockade results in better postoperative recovery than does moderate neuromuscular blockade. Therefore, in this study, we aimed to compare the effects of deep neuromuscular blockade and moderate neuromuscular blockade on the quality of postoperative recovery in patients undergoing robotic gastrectomy. METHODS: In this prospective, double-blind, single-center randomized controlled superiority trial with two parallel groups, 56 adult patients (19-80 years) scheduled for elective robotic gastrectomy were randomly assigned to a moderate neuromuscular blockade group or a deep neuromuscular blockade group in a 1:1 ratio. In the deep and moderate neuromuscular blockade groups, the infusion rate for rocuronium was adjusted to maintain a post-tetanic count of 1-2 or a train-of-four count of 1-2, respectively. The primary outcome was the Quality of Recovery-40 (QoR-40) score on postoperative day 1. Secondary outcomes included the QoR-40 score on postoperative day 2, intraoperative hemodynamic data, intraoperative respiratory data, visual analog scale score for pain, postoperative incidences of nausea and vomiting, postoperative rescue analgesic use, and postoperative rescue antiemetic use. RESULTS: The postoperative QoR-40 score was similar between the two groups on postoperative days 1 and 2. Moreover, the two groups showed no differences in intraoperative hemodynamic and respiratory data or postoperative pain, nausea and vomiting, and rescue medication use. CONCLUSION: Our findings suggest that the quality of recovery after robotic gastrectomy is similar for deep and moderate neuromuscular blockade. Therefore, deep neuromuscular blockade during robotic gastrectomy may be unnecessary, at least in patients with normal body mass index.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1111/aas.13271
DOI
10.1111/aas.13271
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Hwa(김명화) ORCID logo https://orcid.org/0000-0003-4723-9425
Kim, Hyun Joo(김현주) ORCID logo https://orcid.org/0000-0003-1963-8955
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Bai, Sun Joon(배선준) ORCID logo https://orcid.org/0000-0001-5027-3232
Lee, Ki Young(이기영) ORCID logo https://orcid.org/0000-0003-4893-3195
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167477
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