PMID- 35379189
OWN - NLM
STAT- MEDLINE
DCOM- 20220406
LR  - 20220509
IS  - 1471-2253 (Electronic)
IS  - 1471-2253 (Linking)
VI  - 22
IP  - 1
DP  - 2022 Apr 4
TI  - The effects of moderate neuromuscular blockade combined with transverse abdominal 
      plane block on surgical space conditions during laparoscopic colorectal surgery: 
      a randomized clinical study.
PG  - 94
LID - 10.1186/s12871-022-01623-7 [doi]
LID - 94
AB  - BACKGROUND: Deep neuromuscular blockade may be beneficial on surgical space 
      conditions during laparoscopic surgery. The effects of moderate neuromuscular 
      blockade combined with transverse abdominal plane block (TAPB) on surgical space 
      conditions during laparoscopic surgery have not been described. This work 
      investigated whether the above combination is associated with similar surgical 
      space conditions to those of deep neuromuscular blockade. METHODS: Eighty 
      patients undergoing elective laparoscopic surgery for colorectal cancer were 
      randomly divided into two groups. The intervention group was treated with 
      moderate neuromuscular blockade (train-of-four (TOF) count between 1 and 3) 
      combined with TAPB (M group), while the control group was treated with deep 
      neuromuscular blockade (D group), with a TOF count of 0 and a post-tetanic count 
      (PTC) >/=1. Both groups received the same anesthesia management. The distance 
      between the sacral promontory and the umbilical skin during the operation was 
      compared between the two groups. The surgeon scored the surgical space conditions 
      according to a five-point ordinal scale. Patients' pain scores were evaluated 8 h 
      after the operation. RESULTS: The distance from the sacral promontory to the 
      umbilical skin after pneumoperitoneum was similar between the D group and M group 
      (16.03 +/- 2.17 cm versus 16.37 +/- 2.78 cm; P = 0.544). The 95% confidence intervals 
      of the difference in the distance from the sacral promontory to the umbilical 
      skin between the two groups were - 1.45-0.77 cm. According to the preset 
      non-inferior standard of 1.5 cm, (- 1.45, infinity) completely fell within (- 1.50, infinity), 
      and the non-inferior effect test was qualified. No significant difference was 
      found in the surgical rating score between the two groups. The dosage of 
      rocuronium in the group D was significantly higher than that in the group M 
      (P < 0.01). The M group had significantly lower pain scores than the D group 8 h 
      after the operation (P < 0.05). CONCLUSIONS: Moderate neuromuscular blockade 
      combined with TAPB applied to laparoscopic colorectal cancer surgery can provide 
      surgical space conditions similar to those of deep neuromuscular blockade. In 
      addition, it reduces the use of muscle relaxants, relieves postoperative pain 
      within 4 h after operation, and shorten the extubation time and stay in PACU when 
      neostigmine was used as muscle relaxant antagonist. TRIAL REGISTRATION: 
      chictr.org.cn ( ChiCTR2000034621 ), registered on July 12, 2020.
CI  - (c) 2022. The Author(s).
FAU - Ke, Fang
AU  - Ke F
AD  - Department of Anesthesiology, Ruijin Hospital affiliated to Shanghai Jiaotong 
      University School of Medicine, Shanghai, 200025, P.R. China.
FAU - Shen, Zijin
AU  - Shen Z
AD  - Department of Anesthesiology, Ruijin Hospital affiliated to Shanghai Jiaotong 
      University School of Medicine, Shanghai, 200025, P.R. China.
FAU - Wu, Cheng
AU  - Wu C
AD  - Department of Health Statistics, Naval Medical University, Shanghai, 200433, 
      China.
FAU - Zhang, Lin
AU  - Zhang L
AD  - Department of Anesthesiology, Ruijin Hospital affiliated to Shanghai Jiaotong 
      University School of Medicine, Shanghai, 200025, P.R. China.
FAU - Dong, Rong
AU  - Dong R
AD  - Department of Anesthesiology, Ruijin Hospital affiliated to Shanghai Jiaotong 
      University School of Medicine, Shanghai, 200025, P.R. China. sally9132@163.com.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20220404
PL  - England
TA  - BMC Anesthesiol
JT  - BMC anesthesiology
JID - 100968535
RN  - WRE554RFEZ (Rocuronium)
SB  - IM
MH  - Abdominal Muscles
MH  - *Colorectal Surgery
MH  - Humans
MH  - *Laparoscopy
MH  - *Neuromuscular Blockade
MH  - Rocuronium
PMC - PMC8978431
OTO - NOTNLM
OT  - Neuromuscular blockade monitoring
OT  - Surgical space conditions
OT  - Transverse abdominal plane block (TAPB)
COIS- The authors declare that they have no competing interests.
EDAT- 2022/04/06 06:00
MHDA- 2022/04/07 06:00
PMCR- 2022/04/04
CRDT- 2022/04/05 05:27
PHST- 2021/08/17 00:00 [received]
PHST- 2022/03/21 00:00 [accepted]
PHST- 2022/04/05 05:27 [entrez]
PHST- 2022/04/06 06:00 [pubmed]
PHST- 2022/04/07 06:00 [medline]
PHST- 2022/04/04 00:00 [pmc-release]
AID - 10.1186/s12871-022-01623-7 [pii]
AID - 1623 [pii]
AID - 10.1186/s12871-022-01623-7 [doi]
PST - epublish
SO  - BMC Anesthesiol. 2022 Apr 4;22(1):94. doi: 10.1186/s12871-022-01623-7.