Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial

The aim of this study was to investigate whether deep neuromuscular blockade (NMB) may affect intraoperative respiratory mechanics, surgical condition, and recovery profiles in patients undergoing robot-assisted radical prostatectomy (RARP). Patients were randomly assigned to the moderate or deep NM...

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Autores principales:	Chang-Hoon Koo, Insun Park, Sungmin Ahn, Sangchul Lee, Jung-Hee Ryu
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	neuromuscular blockade radical prostatectomy laparoscopy robot-assisted surgery Medicine R
Acceso en línea:	https://doaj.org/article/a15ec8228f3943e2b89fa9f27bf42386
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spelling	oai:doaj.org-article:a15ec8228f3943e2b89fa9f27bf423862021-11-11T17:42:38ZEffect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial10.3390/jcm102150902077-0383https://doaj.org/article/a15ec8228f3943e2b89fa9f27bf423862021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5090https://doaj.org/toc/2077-0383The aim of this study was to investigate whether deep neuromuscular blockade (NMB) may affect intraoperative respiratory mechanics, surgical condition, and recovery profiles in patients undergoing robot-assisted radical prostatectomy (RARP). Patients were randomly assigned to the moderate or deep NMB groups. Pneumoperitoneum was maintained with carbon dioxide (CO<sub>2</sub>) insufflation at 15 mmHg during surgery. The primary outcome was peak inspiratory pressure (PIP) after CO<sub>2</sub> insufflation. Mean airway pressure (P<sub>mean</sub>) and dynamic lung compliance (C<sub>dyn</sub>) were also recorded. The surgeon rated the surgical condition and surgical difficulty on a five-point scale (1 = extremely poor; 2 = poor; 3 = acceptable; 4 = good; 5 = optimal). Recovery profiles, such as pulmonary complications, pain scores, and recovery time, were recorded. We included 58 patients in this study. No significant differences were observed regarding intraoperative respiratory mechanics including PIP, P<sub>mean</sub> and C<sub>dyn</sub>, between the two groups. The number of patients with optimal surgical conditions was significantly higher in the deep than in the moderate NMB group (29 vs. 20, <i>p</i> = 0.014). We found no differences in recovery profiles. In conclusion, deep NMB had no significant effect on the intraoperative respiratory mechanics but resulted in optimal endoscopic surgical conditions during RARP compared with moderate NMB.Chang-Hoon KooInsun ParkSungmin AhnSangchul LeeJung-Hee RyuMDPI AGarticleneuromuscular blockaderadical prostatectomylaparoscopyrobot-assisted surgeryMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5090, p 5090 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	neuromuscular blockade radical prostatectomy laparoscopy robot-assisted surgery Medicine R
spellingShingle	neuromuscular blockade radical prostatectomy laparoscopy robot-assisted surgery Medicine R Chang-Hoon Koo Insun Park Sungmin Ahn Sangchul Lee Jung-Hee Ryu Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial
description	The aim of this study was to investigate whether deep neuromuscular blockade (NMB) may affect intraoperative respiratory mechanics, surgical condition, and recovery profiles in patients undergoing robot-assisted radical prostatectomy (RARP). Patients were randomly assigned to the moderate or deep NMB groups. Pneumoperitoneum was maintained with carbon dioxide (CO<sub>2</sub>) insufflation at 15 mmHg during surgery. The primary outcome was peak inspiratory pressure (PIP) after CO<sub>2</sub> insufflation. Mean airway pressure (P<sub>mean</sub>) and dynamic lung compliance (C<sub>dyn</sub>) were also recorded. The surgeon rated the surgical condition and surgical difficulty on a five-point scale (1 = extremely poor; 2 = poor; 3 = acceptable; 4 = good; 5 = optimal). Recovery profiles, such as pulmonary complications, pain scores, and recovery time, were recorded. We included 58 patients in this study. No significant differences were observed regarding intraoperative respiratory mechanics including PIP, P<sub>mean</sub> and C<sub>dyn</sub>, between the two groups. The number of patients with optimal surgical conditions was significantly higher in the deep than in the moderate NMB group (29 vs. 20, <i>p</i> = 0.014). We found no differences in recovery profiles. In conclusion, deep NMB had no significant effect on the intraoperative respiratory mechanics but resulted in optimal endoscopic surgical conditions during RARP compared with moderate NMB.
format	article
author	Chang-Hoon Koo Insun Park Sungmin Ahn Sangchul Lee Jung-Hee Ryu
author_facet	Chang-Hoon Koo Insun Park Sungmin Ahn Sangchul Lee Jung-Hee Ryu
author_sort	Chang-Hoon Koo
title	Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial
title_short	Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial
title_full	Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial
title_fullStr	Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial
title_full_unstemmed	Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial
title_sort	effect of neuromuscular blockade on intraoperative respiratory mechanics and surgical space conditions during robot-assisted radical prostatectomy: a prospective randomized controlled trial
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a15ec8228f3943e2b89fa9f27bf42386
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Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial

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