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Effect of deep neuromuscular block on the quality of early recovery after sleeve gastrectomy in obese patients: a randomized controlled trial.
- Source :
-
BMC Anesthesiology . 3/16/2024, Vol. 24 Issue 1, p1-9. 9p. - Publication Year :
- 2024
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Abstract
- Background: Deep neuromuscular block (NMB) has been shown to improve surgical conditions and alleviate post-operative pain in bariatric surgery compared with moderate NMB. We hypothesized that deep NMB could also improve the quality of early recovery after laparoscopic sleeve gastrectomy (LSG). Methods: Eighty patients were randomized to receive either deep (post-tetanic count 1–3) or moderate (train-of-four count 1–3) NMB. The QoR-15 questionnaire was used to evaluate the quality of early recovery at 1 day before surgery (T0), 24 and 48 h after surgery (T2, T3). Additionally, we recorded diaphragm excursion (DE), postoperative pain, surgical condition, cumulative dose of analgesics, time of first flatus and ambulation, post-operative nausea and vomiting, time of tracheal tube removal and hospitalization time. Main results: The quality of recovery was significantly better 24 h after surgery in patients who received a deep versus moderate block (114.4 ± 12.9 versus 102.1 ± 18.1). Diaphragm excursion was significantly greater in the deep NMB group when patients performed maximal inspiration at T2 and T3 (P < 0.05). Patients who underwent deep NMB reported lower visceral pain scores 40 min after surgery; additionally, these patients experienced lower pain during movement at T3 (P < 0.05). Optimal surgical conditions were rated in 87.5% and 64.6% of all measurements during deep and moderate NMB respectively (P < 0.001). The time to tracheal tube removal was significantly longer in the deep NMB group (P = 0.001). There were no differences in other outcomes. Conclusion: In obese patients receiving deep NMB during LSG, we observed improved QoR-15 scores, greater diaphragmatic excursions, improved surgical conditions, and visceral pain scores were lower. More evidence is needed to determine the effects of deep NMB on these outcomes. Trial registration: ChiCTR2200065919. Date of retrospectively registered: 18/11/2022. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BARIATRIC surgery
*GASTRECTOMY
*DIAPHRAGM (Anatomy)
*POSTOPERATIVE pain
*STATISTICAL sampling
*QUESTIONNAIRES
*HOSPITAL care
*TREATMENT effectiveness
*RANDOMIZED controlled trials
*EARLY ambulation (Rehabilitation)
*DESCRIPTIVE statistics
*MEDICAL device removal
*PRE-tests & post-tests
*ANALGESICS
*SURGICAL complications
*CONVALESCENCE
*NEUROMUSCULAR blockade
*POSTOPERATIVE period
*COMPARATIVE studies
*VOMITING
*NAUSEA
Subjects
Details
- Language :
- English
- ISSN :
- 14712253
- Volume :
- 24
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- BMC Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 176079319
- Full Text :
- https://doi.org/10.1186/s12871-024-02465-1