Full Text:   <1658>

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CLC number: R656

On-line Access: 2020-08-04

Received: 2020-04-11

Revision Accepted: 2020-05-21

Crosschecked: 2020-07-20

Cited: 0

Clicked: 2949

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Kui-rong Wang

https://orcid.org/0000-0001-9608-3119

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Journal of Zhejiang University SCIENCE B 2020 Vol.21 No.8 P.637-645

http://doi.org/10.1631/jzus.B2000193


Comparison of the effects of deep and moderate neuromuscular block on respiratory system compliance and surgical space conditions during robot-assisted laparoscopic radical prostatectomy: a randomized clinical study


Author(s):  Shao-jun Zhu, Xiao-lin Zhang, Qing Xie, Yan-feng Zhou, Kui-rong Wang

Affiliation(s):  Department of Anesthesiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China

Corresponding email(s):   wangkr@zju.edu.cn

Key Words:  Robot-assisted radical prostatectomy (RARP), Deep neuromuscular block, Respiratory mechanics, Surgical space condition


Shao-jun Zhu, Xiao-lin Zhang, Qing Xie, Yan-feng Zhou, Kui-rong Wang. Comparison of the effects of deep and moderate neuromuscular block on respiratory system compliance and surgical space conditions during robot-assisted laparoscopic radical prostatectomy: a randomized clinical study[J]. Journal of Zhejiang University Science B, 2020, 21(8): 637-645.

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author="Shao-jun Zhu, Xiao-lin Zhang, Qing Xie, Yan-feng Zhou, Kui-rong Wang",
journal="Journal of Zhejiang University Science B",
volume="21",
number="8",
pages="637-645",
year="2020",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2000193"
}

%0 Journal Article
%T Comparison of the effects of deep and moderate neuromuscular block on respiratory system compliance and surgical space conditions during robot-assisted laparoscopic radical prostatectomy: a randomized clinical study
%A Shao-jun Zhu
%A Xiao-lin Zhang
%A Qing Xie
%A Yan-feng Zhou
%A Kui-rong Wang
%J Journal of Zhejiang University SCIENCE B
%V 21
%N 8
%P 637-645
%@ 1673-1581
%D 2020
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2000193

TY - JOUR
T1 - Comparison of the effects of deep and moderate neuromuscular block on respiratory system compliance and surgical space conditions during robot-assisted laparoscopic radical prostatectomy: a randomized clinical study
A1 - Shao-jun Zhu
A1 - Xiao-lin Zhang
A1 - Qing Xie
A1 - Yan-feng Zhou
A1 - Kui-rong Wang
J0 - Journal of Zhejiang University Science B
VL - 21
IS - 8
SP - 637
EP - 645
%@ 1673-1581
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B2000193


Abstract: 
Objective: robot-assisted radical prostatectomy (RARP) requires pneumoperitoneum (Pnp) and a steep head-down position that may disturb respiratory system compliance (Crs) during surgery. Our aim was to compare the effects of different degrees of neuromuscular block (NMB) on Crs with the same Pnp pressure during RARP. Methods: One hundred patients who underwent RARP were enrolled and randomly allocated to a deep or moderate NMB group with 50 patients in each group. Rocuronium was administered to both groups: in the moderate NMB group to maintain 1–2 responses to train-of-four (TOF) stimulation; and in the deep NMB group to maintain no response to TOF stimulation and 1–2 responses in the post-tetanic count. Pnp pressure in both groups was 10 mmHg (1 mmHg=133.3 Pa). Peak inspiratory pressure (Ppeak), mean pressure (Pmean), Crs, and airway resistance (Raw) were recorded after anesthesia induction and at 0, 30, 60, and 90 min of Pnp and post-Pnp. surgical space conditions were evaluated after the procedure on a 4-point scale. Results: Immediately after the Pnp, Ppeak, Pmean, and Raw significantly increased, while Crs decreased and persisted during Pnp in both groups. The results did not significantly differ between the two groups at any of the time points. There was no difference in surgical space conditions between groups. Body movements occurred in 14 cases in the moderate NMB group and in one case in the deep NMB group, and all occurred during obturator lymphadenectomy. A significant difference between the two groups was observed. Conclusions: Under the same Pnp pressure in RARP, deep and moderate NMBs resulted in similar changes in Crs, and in other respiratory mechanics and surgical space conditions. However, deep NMB significantly reduced body movements during surgery.

深度神经肌肉阻滞对机器人辅助腹腔镜前列腺癌根治术呼吸顺应性和手术条件的影响:随机临床研究

目的:机器人辅助前列腺癌根治术中需要头低位和气腹,这将严重干扰呼吸顺应性(Crs).本研究比较机器人辅助腹腔镜前列腺癌根治术在相同气腹压力下不同程度的神经肌肉阻滞对Crs的影响.
创新点:不同深度神经肌肉阻滞对机器人辅助前列腺癌根治术Crs的观察.
方法:将100例接受机器人辅助腹腔镜前列腺癌根治术的患者随机分配到中度神经肌肉阻滞组和深度神经肌肉阻滞组,每组50例.应用罗库溴铵维持神经肌肉阻滞.保持对4个成串刺激1~2个反应为中度神经肌肉阻滞组;对4个成串刺激无反应,而对强直后刺激1~2个反应为深度神经肌肉阻滞组.两组气腹压力均为10 mmHg.记录麻醉诱导后及气腹0、30、60和90 min的吸气峰值压力、平均压力、Crs和气道阻力.手术结束时对手术条件进行评估.
结论:在机器人辅助腹腔镜前列腺癌根治术中,相同的气腹压力下,深度神经肌肉阻滞不能改善Crs和手术条件,但能显著降低术中体动.

关键词:机器人辅助前列腺癌根治术;深度神经肌肉阻滞;呼吸力学;手术条件

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

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