Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Sungnam, Korea.
Deparment of Anesthesiology and Pain Medicine, Seoul National University School of Medicine, Seoul, Korea.
Anaesthesia. 2017 Oct;72(10):1185-1190. doi: 10.1111/anae.13894. Epub 2017 May 11.
Some short procedures require deep neuromuscular blockade, which needs to be reversed at the end of the procedure. Forty-four patients undergoing elective laryngeal micro-surgery were randomly allocated into two groups: rocuronium 0.45 mg.kg with neostigmine (50 μg.kg with glycopyrrolate 10 μg.kg ) reversal (moderate block group) vs. rocuronium 0.90 mg.kg with sugammadex (4 mg.kg ) reversal (deep block group). The primary outcome was the intubating conditions during laryngoscopy secondary outcomes included recovery of neuromuscular block; conditions for tracheal intubation; satisfaction score as determined by the surgeon; onset of neuromuscular block; and postoperative sore throat. The onset of neuromuscular block was more rapid, and intubation conditions and ease of intra-operative laryngoscopy were more favourable, and the satisfaction score was lower in the moderate block group compared with the deep block group. No difference was found in the incidence of postoperative sore throat. In laryngeal micro-surgery, the use of rocuronium 0.9 mg.kg with sugammadex for reversal was associated with better surgical conditions and a shorter recovery time than rocuronium 0.45 mg.kg with neostigmine.
在一些短小的手术中需要深度神经肌肉阻滞，这需要在手术结束时进行逆转。44 名接受择期喉部微创手术的患者被随机分为两组：罗库溴铵 0.45mg/kg 联合新斯的明（50μg/kg 加格隆溴铵 10μg/kg）逆转（中度阻滞组）与罗库溴铵 0.90mg/kg 联合琥珀胆碱（4mg/kg）逆转（深度阻滞组）。主要结局是喉镜检查时的插管条件，次要结局包括神经肌肉阻滞的恢复情况；气管插管条件；术者满意度评分；神经肌肉阻滞的起始时间；以及术后咽喉痛。中度阻滞组的神经肌肉阻滞起效更快，插管条件和术中喉镜检查的便利性更好，满意度评分也低于深度阻滞组。两组术后咽喉痛的发生率无差异。在喉部微创手术中，使用罗库溴铵 0.9mg/kg 联合琥珀胆碱逆转与使用罗库溴铵 0.45mg/kg 联合新斯的明相比，手术条件更好，恢复时间更短。
