Department of Anaesthesiology and Intensive Therapy, BarlickiUniversity Hospital, Medical University of Lodz, Poland.
Br J Anaesth. 2012 Feb;108(2):236-9. doi: 10.1093/bja/aer330. Epub 2011 Oct 19.
Complete and fast recovery of neuromuscular function is very important in morbidly obese patients because of the possible influence of postoperative residual curarization (PORC) on respiratory function in the postoperative period. Recent reports underline incidences of the residual influence of neuromuscular blocking agents.
Seventy morbidly obese (BMI >40 kg m(-2)) patients requiring general anaesthesia and receiving rocuronium for muscle relaxation were randomly assigned into two groups: at the end of the anaesthetic procedure, one group received sugammadex 2 mg kg(-1) of corrected body weight (Group SUG) and the other group received neostigmine 0.05 mg kg(-1) of CBW (Group NEO). At the end of surgery and when response reached a train-of-four (TOF) score of 2, patients received the study drugs. The neuromuscular function was recorded and time to achieve 90% of TOF (safe extubation) was measured. Patients were examined directly after arrival to the post-anaesthesia care unit (PACU) by a blinded investigator for the presence of PORC.
Thirty-five patients received sugammadex and 35 neostigmine. Mean dose of rocuronium was 87.9 vs 85.6 mg (P>0.05), mean time to 90% of TOF was 2.7 vs 9.6 min (P<0.05), and TOF at the PACU was 109.8% vs 85.5% (P<0.05) in Groups SUG and NEO, respectively.
Administration of sugammadex provides fast recovery of neuromuscular function and prevents PORC in the morbidly obese, however neostigmine does not.
由于术后残余肌松（PORC）可能对术后呼吸功能产生影响，病态肥胖患者的神经肌肉功能需要完全且快速恢复。最近的报告强调了神经肌肉阻滞剂残留影响的发生率。
70 例病态肥胖（BMI＞40kg/m²）患者需全身麻醉并接受罗库溴铵肌松，随机分为两组：麻醉程序结束时，一组给予舒更葡糖钠 2mg/kg 矫正体重（SUG 组），另一组给予新斯的明 0.05mg/kg 矫正体重（NEO 组）。手术结束时，当肌颤搐达到 4 个成串刺激（TOF）的 2 倍时，患者接受研究药物。记录神经肌肉功能，并测量达到 90%TOF（安全拔管）的时间。患者在直接到达麻醉后监护病房（PACU）后由一名盲法研究者检查 PORC 的存在情况。
35 例患者接受舒更葡糖钠，35 例患者接受新斯的明。罗库溴铵的平均剂量分别为 87.9mg 和 85.6mg（P＞0.05），达到 90%TOF 的平均时间分别为 2.7min 和 9.6min（P＜0.05），TOF 在 PACU 时分别为 109.8%和 85.5%（P＜0.05）。
舒更葡糖钠的给药可使病态肥胖患者的神经肌肉功能快速恢复，并预防 PORC，但新斯的明则不能。
