| Effects of neuromuscular blockade on pulmonary function in patients undergoing laparoscopic cholecystectomy |
| Received:May 30, 2020 Revised:September 08, 2020 Click here to download the full text |
| Citation of this paper:WANG Fang,ZHOU Jian-wen,YAO Yi-zhen,TANG Jun.Effects of neuromuscular blockade on pulmonary function in patients undergoing laparoscopic cholecystectomy[J].Chinese Journal of Clinical Medicine,2020,27(6):1011-1016 |
| Hits: 1128 |
| Download times: 412 |
| Author Name | Affiliation | E-mail | | WANG Fang | Department of Anesthesiology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China | | | ZHOU Jian-wen | Department of Anesthesiology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China | | | YAO Yi-zhen | Department of Anesthesiology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China | | | TANG Jun | Department of Anesthesiology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China | TJWY2575@126.com |
|
| Abstract:Objective:To explore the effect of different degrees of neuromuscular blockade on pulmonary function in patients undergoing laparoscopic cholecystectomy.Methods:Ninety patients were selected from Shanghai Fifth People's Hospital, Fudan University from September 2018 to January 2020, scheduled for elective laparoscopic cholecystectomy were randomly arranged into 3 groups (n=30 in each group) using a random number table: shallow neuromuscular blockade group (Group S), moderate neuromuscular blockade group (Group M), and deep neuromuscular blockade group (Group D). Rocuronium was infused to maintain the degree of neuromuscular blockade in three groups to achieve the target degrees: train-of-four count (TOF) of 4 in group S, TOF 1-3 in group M, and post-tetanic count (PTC) ≤2 in group D. Peak airway pressure (Ppeak), airway plateau pressure (Pplat), and lung dynamic compliance (CL) were recorded at following time points: just after tracheal intubation (T1), 10 min after pneumoperitoneum (T2), immediately at the end of pneumoperjtoneum (T3) and end of surgery (T4). Artefial blood samples were collected for blood gas analysis at T1, T2, and T4, oxygenation index (OI), respiratory index (RI), and intrapulmonary shunt (Qs/Qt) were calculated derivatively. Extubation time and dosages of rocuronium were recorded, while surgical condition scores were assessed by surgeons.Results:Compared with group S, CL and OI were significantly higher, while RI and Qs/Qt were lower at T2 in groups M and D (P<0.01), but there was no difference at T4. Surgery condition scores were higher and extubation time was longer in group M and D than those in Group S (P<0.01), the dosages of rocuronium in group M and D were higher than that in group S (P<0.05, P< 0.01). Furthermore, extubation time in group D was 11 min longer and the dosage of rocuronium was higher than that in group M (P<0.01), but other parameters did not show any significant differences between the two groups. Ppeak and Pplat did not show statistical differences among the three groups.Conclusions:Moderate neuromuscular blockade can provide similar surgical conditions as deep neuromuscular blockade, and improve pulmonary function during pneumoperitoneum for laparoscopic cholecystectomy, and require shorter extubation time. It may be a more appropriate neuromuscular blockade approach for laparoscopic cholecystectomy. |
| keywords:neuromuscular block laparoscopic surgery respiratory function tests |
| HTML View Full Text View/Add Comment Download reader |
|
|
|