Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/95480
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Deep neuromuscular block reduces intra-abdominal pressure requirements during laparoscopic cholecystectomy: a prospective observational study
Author: Van Wijk, R.
Watts, R.
Ledowski, T.
Trochsler, M.
Moran, J.
Arenas, G.
Citation: Acta Anaesthesiologica Scandinavica: an international journal of anaesthesiology and intensive care, pain and emergency medicine, 2015; 59(4):434-440
Publisher: Wiley
Issue Date: 2015
ISSN: 0001-5172
1399-6576
Statement of
Responsibility: 
R. M. Van Wijk, R.W. Watts, T. Ledowski, M. Trochsler, J.L. Moran and G.W.N. Arenas
Abstract: BACKGROUND: Laparoscopic surgery causes specific post-operative discomfort and intraoperative cardiovascular, pulmonary, and splanchnic changes. The CO₂ pneumoperitoneum-related intra-abdominal pressure (IAP) remains one of the main drivers of these changes. We investigated the influence of deep neuromuscular blockade (NMB) on IAP and surgical conditions. METHODS: This is an open prospective single-subject design study in 20 patients (14 female/6 male) undergoing laparoscopic cholecystectomy. Inclusion criteria were 18 years or older, and American Society of Anesthesiologists classification 1 to 3. Under a standardised anaesthesia, lowest IAP providing adequate surgical conditions was assessed without NMB and with deep NMB [post-tetanic count (PTC)<2] with rocuronium. The differences between IAP allowing for an adequate surgical field before and after administration of rocuronium were determined, as were effects of patient gender, age, and body mass index. RESULTS: Mean IAP without NMB was 12.75 (standard deviation 4.49) mmHg. Immediately after achieving a deep NMB, this was 7.20 (2.51). This pressure difference of 5.55 mmHg (5.08, P<0.001) dropped to 3.00 mmHg (4.30, P<0.01) after 15 min. Higher IAP differences were found in women compared with men. A modest inverse relationship was found between pressure difference and age. CONCLUSIONS: We found an almost 25% lower IAP after a deep NMB compared with no block in laparoscopic cholecystectomy. Younger and female patients appear to benefit more from deep neuromuscular blockade to reduce IAP.
Keywords: Abdomen
Humans
Androstanols
Neuromuscular Nondepolarizing Agents
Neuromuscular Blockade
Cholecystectomy, Laparoscopic
Prospective Studies
Pressure
Adolescent
Adult
Aged
Aged, 80 and over
Middle Aged
Female
Male
Young Adult
Rocuronium
Rights: © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
DOI: 10.1111/aas.12491
Appears in Collections:Aurora harvest 7
Medicine publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.