Deep Neuromuscular Block Affect the Quality of Recovery After Laparoscopic Hysterectomy

Anqing Municipal Hospital72 enrolled

Overview

BACKGROUND: Some studies have revealed that deep neuromuscular block (NMB) improve surgical conditions and alleviated postoperative pain compared with moderate NMB. The present study investigated deep NMB could improve the quality of recovery after laparoscopic hysterectomy METHODS: seventy-two women with elective laparoscopic hysterectomy were randomly divided into 2 groups: Patients in group A received low-pressure pneumoperitoneum (LPP), which was set at 8-10 mmHg with deep NMB. Patients in group B received standard-pressure pneumoperitoneum (SPP), which was set at 12-14 mmHg with moderate NMB. Primary outcome was the quality of recovery (QoR-15) at 1 day after sugery. The secondary outcomes included postoperative pain, surgical condition, incidence of shoulder pain, the incidence of rescue analgesic drug use, cumulative dose of analgesics, time of first flatus, post-operative nausea and vomiting, time of tracheal tube removal.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Neuromuscular Blockade Laparoscopy

Interventions

Eligibility

Sex: FEMALEMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists (ASA) physical status Ⅰ- Ⅲ * Scheduled for elective laparoscopic hysterectomy Exclusion Criteria: * Inability to give informed consent * BMI \>35 * Renal or hepatic insufficiency * History of preoperative psychiatric * Previous surgery at procedure site * Neuromuscular disease, pregnancy, and contraindications to study medications.

Outcomes

Primary Outcomes

Quality of recovery

Primary outcome measure was the quality of recovery at 1 day after surgery. Quality of recovery-15 scale was used to assess the quality of recovery after operation. A higher score of quality of recovery-15 scale indicates a better quality of recovery after surgery

Time frame: 1 day after operation

Secondary Outcomes

Shoulder pain

Secondary Outcome Measure was the incidence of shoulder pain

Time frame: The first 24 hours after operation

Postoperative nausea and vomiting

Secondary Outcome Measure was the incidence of postoperative nausea and vomiting. PONV score was evaluated verbally with a descriptive scale (0 = None, 1 = Mild Nausea, 2 = Moderate Nausea, 3 = One Vomiting, 4 = Multiple Vomiting).