Department of Anaesthesia, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Anaesthesia. 2014 Aug;69(8):854-9. doi: 10.1111/anae.12707. Epub 2014 May 12.
We investigated whether laparoscopic vs open surgical approaches affected the duration of neuromuscular blockade following a single bolus dose of rocuronium. Fifty-three female patients underwent either laparoscopic or open gynaecological surgery. Rocuronium 0.6 mg.kg(-1) was administered to achieve neuromuscular blockade in all subjects, and adductor pollicis train-of-four responses following ulnar nerve stimulation were monitored with mechanomyography. The mean (SD) time from injection of rocuronium until spontaneous recovery of the first twitch, and to 5% and 25% of baseline, was significantly prolonged in the laparoscopic group (27.2 (8.3) min, 31.3 (9.1) min and 38.1 (10.6) min, respectively) compared with the open surgery group (21.1 (5.8) min, 25.6 (6.3) min and 31.2 (6.7) min, respectively). Changes in liver function both before surgery and at 24 h postoperatively were similar between the two groups (p > 0.05). Our findings suggest that neuromuscular blockade may be prolonged following a single bolus dose of rocuronium given during laparoscopic procedures.
我们研究了单次罗库溴铵推注后腹腔镜与开放手术入路是否影响神经肌肉阻滞的持续时间。53 名女性患者接受了腹腔镜或开腹妇科手术。所有患者均给予罗库溴铵 0.6mg/kg 以达到神经肌肉阻滞，并使用肌电图监测尺神经刺激后的拇内收肌肌阵挛反应。与开放手术组（分别为 21.1（5.8）min、25.6（6.3）min 和 31.2（6.7）min）相比，腹腔镜组（分别为 27.2（8.3）min、31.3（9.1）min 和 38.1（10.6）min）从罗库溴铵注射到第一个颤搐自发恢复以及恢复至基线的 5%和 25%的时间明显延长。两组患者术前和术后 24 小时的肝功能变化相似（p>0.05）。我们的研究结果表明，单次罗库溴铵推注后腹腔镜手术可能会延长神经肌肉阻滞时间。
