Cho Hyun Chul, Lee Jong Hwan, Lee Seung Cheol, Park Sang Yoong, Rim Jong Cheol, Choi So Ron
Department of Anesthesiology and Pain Medicine, Dong-A University Hospital, Busan, Korea.
Korean J Anesthesiol. 2017 Aug;70(4):420-425. doi: 10.4097/kjae.2017.70.4.420. Epub 2017 Apr 21.
This study aimed to retrospectively evaluate the use of sugammadex in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy.
Data were obtained from medical record review of patients who underwent VATS lobectomy from January 2013 to November 2014. Fifty patients were divided into two groups: the sugammadex group (group S, n = 19) was administered sugammadex 2 mg/kg, while the pyridostigmine group (group P, n = 31) received pyridostigmine 20 mg with glycopyrrolate 0.2 mg or atropine 0.5 mg. The primary endpoint measure was the overall incidence of postoperative pulmonary complications including prolonged air leak, pneumonia, and atelectasis. The secondary endpoint measures were the length of postoperative hospital stay and duration of chest tube insertion.
The overall incidence of postoperative pulmonary complications in patients in group S was significantly lower compared with that of group P (5 [26.3%] vs. 17 [54.8%]; P = 0.049). Also, the durations of chest tube insertion (5.0 [4.0-7.0] vs. 7.0 [6.0-8.0] days; P = 0.014) and postoperative hospital stay (8.0 [8.0-10.0] vs. 10.0 [9.0-11.0] days; P = 0.019) were shorter in group S compared with group P. Administration of sugammadex was associated reduced with postoperative pulmonary complications (OR: 0.22; 95% CI: 0.05-0.87; P = 0.031).
The use of sugammadex, compared with pyridostigmine, showed a significantly reduced overall incidence of postoperative pulmonary complications and decreased duration of chest tube use and postoperative hospital stay in patients undergoing VATS lobectomy, suggesting that sugammadex might be helpful in improving clinical outcomes in such patients.
本研究旨在回顾性评估舒更葡糖在接受电视辅助胸腔镜手术(VATS)肺叶切除术患者中的应用。
数据来自于对2013年1月至2014年11月期间接受VATS肺叶切除术患者的病历回顾。50例患者分为两组:舒更葡糖组(S组,n = 19)给予舒更葡糖2 mg/kg,而新斯的明组(P组,n = 31)接受新斯的明20 mg加格隆溴铵0.2 mg或阿托品0.5 mg。主要终点指标是术后肺部并发症的总体发生率,包括持续漏气、肺炎和肺不张。次要终点指标是术后住院时间和胸管留置时间。
S组患者术后肺部并发症的总体发生率显著低于P组(5 [26.3%] 对17 [54.8%];P = 0.049)。此外,S组的胸管留置时间(5.0 [4.0 - 7.0]天对7.0 [6.0 - 8.0]天;P = 0.014)和术后住院时间(8.0 [8.0 - 10.0]天对10.0 [9.0 - 11.0]天;P = 0.019)均短于P组。使用舒更葡糖与术后肺部并发症减少相关(比值比:0.22;95%可信区间:0.05 - 0.87;P = 0.031)。
与新斯的明相比,舒更葡糖的使用在接受VATS肺叶切除术的患者中显示出术后肺部并发症的总体发生率显著降低,胸管使用时间和术后住院时间缩短,提示舒更葡糖可能有助于改善此类患者的临床结局。