Scholarlink

Background <p>The sustained administration of deep neuromuscular blockade (NMB) improves surgical conditions compared to moderate NMB and might be effective in the laparoscopic Roux-en-Y gastric bypass (LRYGB). This study aimed to evaluate the effect of sustained intravenous deep NMB on improving surgical conditions and pain intensity following LRYGB.</p> Methods <p>This randomized, double-blind clinical trial was conducted in São Luís, Maranhão, Brazil, between October 2021 and December 2023. Patients undergoing LRYGB were randomly assigned to moderate (reversed with 2&#xa0;mg/kg of sugammadex) or deep NMB (reversed with 4&#xa0;mg/kg of sugammadex).</p> Results <p>Seventy-one patients were evaluated in the study, divided into moderate NMB with 37 patients and deep NMB group with 34 patients. There was no difference between the groups regarding gender, age, weight, height, and comorbidities. Also, in the duration of anesthesia (moderate, 2&#xa0;h 26&#xa0;min; deep, 2&#xa0;h 27&#xa0;min; <i>p</i> = 0.876), duration of surgery (moderate, 1&#xa0;h 39&#xa0;min; deep NMB: 1&#xa0;h 40&#xa0;min; <i>p</i> = 0.931), time to extubation (moderate, 5&#xa0;min; deep, 7&#xa0;min; <i>p</i> = 0.252), time to the first morphine request (moderate, 30&#xa0;min; deep, 25&#xa0;min on average; <i>p</i> = 0.776), mean morphine consumption in 24&#xa0;h (moderate, 14&#xa0;mg; deep, 10&#xa0;mg; <i>p</i> = 0.133), and sevoflurane consumption (moderate, 50&#xa0;mL; deep 50&#xa0;mL; <i>p</i> = 0.884). There was no&#xa0;significant difference between the groups in pain scores at none of the evaluated moments.&#xa0;The Leiden-Surgical Rating Scale revealed a significant difference between the groups at 20/30&#xa0;min (<i>p</i> = 0.015) and 60/70&#xa0;min (<i>p</i> = 0.027), respectively. </p> Conclusion <p>This study demonstrated improved surgical field visibility with deep compared to moderate NMB, without significant differences in other evaluated variables.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Evaluation of Postoperative Pain and Visual Field in Patients Undergoing Laparoscopic Roux-en-Y Gastric Bypass Under Moderate and Deep Neuromuscular Blockade: Randomized Clinical Trial

  • 期刊论文

  • 发表日期：

    2025年2月11日

查看全文
  • Marcelo Nogueira Cruz da Silva,
  • Ed Carlos Rey Moura,
  • Caio Marcio Barros Oliveira,
  • João Nogueira Neto,
  • Roclides Castro de Lima,
  • Almir Vieira Dibai Filho,
  • José Aparecido Valadão,
  • Hiago Parreão Braga,
  • Plínio da Cunha Leal

摘要

Background

The sustained administration of deep neuromuscular blockade (NMB) improves surgical conditions compared to moderate NMB and might be effective in the laparoscopic Roux-en-Y gastric bypass (LRYGB). This study aimed to evaluate the effect of sustained intravenous deep NMB on improving surgical conditions and pain intensity following LRYGB.

Methods

This randomized, double-blind clinical trial was conducted in São Luís, Maranhão, Brazil, between October 2021 and December 2023. Patients undergoing LRYGB were randomly assigned to moderate (reversed with 2 mg/kg of sugammadex) or deep NMB (reversed with 4 mg/kg of sugammadex).

Results

Seventy-one patients were evaluated in the study, divided into moderate NMB with 37 patients and deep NMB group with 34 patients. There was no difference between the groups regarding gender, age, weight, height, and comorbidities. Also, in the duration of anesthesia (moderate, 2 h 26 min; deep, 2 h 27 min; p = 0.876), duration of surgery (moderate, 1 h 39 min; deep NMB: 1 h 40 min; p = 0.931), time to extubation (moderate, 5 min; deep, 7 min; p = 0.252), time to the first morphine request (moderate, 30 min; deep, 25 min on average; p = 0.776), mean morphine consumption in 24 h (moderate, 14 mg; deep, 10 mg; p = 0.133), and sevoflurane consumption (moderate, 50 mL; deep 50 mL; p = 0.884). There was no significant difference between the groups in pain scores at none of the evaluated moments. The Leiden-Surgical Rating Scale revealed a significant difference between the groups at 20/30 min (p = 0.015) and 60/70 min (p = 0.027), respectively.

Conclusion

This study demonstrated improved surgical field visibility with deep compared to moderate NMB, without significant differences in other evaluated variables.