Comparison of the effects of deep and moderate neuromuscular block on respiratory system compliance and surgical space conditions during robot-assisted laparoscopic radical prostatectomy: a randomized clinical study

作     者：Shao-jun ZHU Xiao-lin ZHANG Qing XIE Yan-feng ZHOU Kui-rong WANG Shao-jun ZHU;Xiao-lin ZHANG;Qing XIE;Yan-feng ZHOU;Kui-rong WANG

作者机构：Department of Anesthesiologythe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China 

出 版 物：《Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)》 (浙江大学学报（英文版）B辑（生物医学与生物技术）)

年 卷 期：2020年第21卷第8期

页      面：637-645页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Project supported by the Zhejiang Province Public Welfare Technology Application Research Project(No.LGF20H010006) China 

主　　题：Robot-assisted radical prostatectomy(RARP) Deep neuromuscular block Respiratory mechanics Surgical space condition 

摘      要：Objective:Robot-assisted radical prostatectomy(RARP)requires pneumoperitoneum(Pnp)and a steep head-down position that may disturb respiratory system compliance(Crs)during *** aim was to compare the effects of different degrees of neuromuscular block(NMB)on Crs with the same Pnp pressure during ***:One hundred patients who underwent RARP were enrolled and randomly allocated to a deep or moderate NMB group with 50 patients in each *** was administered to both groups:in the moderate NMB group to maintain 1–2 responses to train-of-four(TOF)stimulation;and in the deep NMB group to maintain no response to TOF stimulation and 1–2 responses in the post-tetanic *** pressure in both groups was 10 mm Hg(1 mm Hg=133.3 Pa).Peak inspiratory pressure(Ppeak),mean pressure(Pmean),Crs,and airway resistance(Raw)were recorded after anesthesia induction and at 0,30,60,and 90 min of Pnp and *** space conditions were evaluated after the procedure on a 4-point ***:Immediately after the Pnp,Ppeak,Pmean,and Raw significantly increased,while Crs decreased and persisted during Pnp in both *** results did not significantly differ between the two groups at any of the time *** was no difference in surgical space conditions between *** movements occurred in 14 cases in the moderate NMB group and in one case in the deep NMB group,and all occurred during obturator lymphadenectomy.A significant difference between the two groups was ***:Under the same Pnp pressure in RARP,deep and moderate NMBs resulted in similar changes in Crs,and in other respiratory mechanics and surgical space ***,deep NMB significantly reduced body movements during surgery.