ObjectiveTo investigate the effect of deep neuromuscular blockade on postoperative rehabilitation of patients undergoing laparoscopic colorectal-carcinoma surgery.
MethodsSeventy-eight patients undergoing laparoscopic colorectal-carcinoma surgery were randomly divided into two groups as moderate neuromuscular blockade group(Group A, n=39) and deep neuromuscular blockade group(Group B, n=39).Patients in group A were pumped with cisatracurium under muscle relaxation monitoring to maintain the level of modern neuromuscular blockade.Other patients in group B were pumped with cisatracurium under muscle relaxation monitoring to maintain the level of deep neuromuscular blockade.Goal-directed fluid therapy was performed for intraoperative volume management in both groups.After entering the postanesthesia care unit, neuromuscular blockade monitoring was continued for patients in both groups.Then, muscle relaxation antagonists and extubation of endotracheal tubes were performed in both groups under the guidance of neuromuscular monitoring.The surgical field score, mean pneumoperitoneum pressure, and mean airway pressure were recorded; the time of recovery index, the time of removing the tracheal intubation, and the stay time in the postanesthesia care unit were recorded; the scores of postoperative pain, nausea, and vomiting were recorded; the score of recovery quality scale, recovery of gastrointestinal function, and hospital stay were recorded.
ResultsThe mean artificial pneumoperitoneum pressure and mean airway pressure in group B were lower than those in group A(P < 0.01).The usage of cisatracurium, the time of TOF ratio from 0.25 to 0.75, and the time of removing the tracheal intubation in group B were higher than those in group A(P < 0.01).The shoulder pain scores of patients in group B were lower than those in group A at all postoperative periods(P < 0.01).At 6 and 24 hours after operation, the scores of visceral pain, nausea, and vomiting in group B were lower than those in group A(P < 0.01).At 1 and 3 days after operation, the score of recovery quality in group B was higher than that in group A(P < 0.01).The exhaust time, defecation time, bowel sound recovery time and hospital stay in group B were shorter than those in group A(P < 0.01).
ConclusionsThe application of deep neuromuscular blockade in laparoscopic colorectal-carcinoma surgery can reduce the pneumoperitoneum pressure under the premise of ensuring the surgical field, improve the early postoperative recovery quality of patients, promote the gastrointestinal function recovery, and benefit the postoperative rehabilitation of patients, providing ideas for perioperative anesthesia management.
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