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Influence of Deep Neuromuscular Blockade on Perioperative Stress Response in Patients Undergoing Robot-Assisted Gastrectomy: A Prospective Double-Blinded Randomized-Controlled Trial

 Myoung Hwa Kim  ;  Na Young Kim  ;  Young Chul Yoo  ;  Hee Jung Kong  ;  Hye Sun Lee  ;  Arim Jo  ;  Sun Joon Bai 
 JOURNAL OF PERSONALIZED MEDICINE, Vol.11(12) : 1308, 2021-12 
Journal Title
Issue Date
neuromuscular blockade ; robotic surgery ; stress response ; postoperative recovery
Attenuating the intraoperative stress response is crucial; however, the effect of neuromuscular blockade (NMB) on surgical stress is not completely understood. We aimed to investigate the effects of NMB on the perioperative stress response during robot-assisted gastrectomy. Patients were assigned to the deep or moderate NMB group. Serum cortisol, prolactin, and interleukin-6 (IL-6) levels and natural killer (NK) cell percentage were measured before anesthesia induction, 90 min after pneumoperitoneum, operation end (OPEnd), and postoperative day 1. Additionally, C-reactive protein (CRP) and albumin levels were estimated. Additionally, intraoperative heart rate variability was evaluated. The deep NMB group showed significantly lower levels of low-frequency/high-frequency (HF) ratio at OPEnd compared to the moderate NMB group (1.4 ± 0.2 vs. 2.2 ± 0.3, respectively; Bonferroni corrected p = 0.039). Furthermore, HF power in the deep NMB group was significantly higher at OPEnd than that in the moderate NMB group (45.2 ± 3.6 vs. 33.8 ± 4.0, respectively; Bonferroni corrected p = 0.044). However, no significant differences in cortisol, prolactin, IL-6, CRP, and albumin levels and NK cell percentage were found between the two groups. The degree of NMB may have similar effects on stress-related biological markers in patients undergoing robot-assisted gastrectomy.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kong, Hee Jung(공희정)
Kim, Na Young(김나영) ORCID logo https://orcid.org/0000-0003-3685-2005
Kim, Myoung Hwa(김명화) ORCID logo https://orcid.org/0000-0003-4723-9425
Bai, Sun Joon(배선준) ORCID logo https://orcid.org/0000-0001-5027-3232
Yoo, Young Chul(유영철) ORCID logo https://orcid.org/0000-0002-6334-7541
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
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