Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Department of Anesthesiology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Biomed Res Int. 2018 Feb 15;2018:9491750. doi: 10.1155/2018/9491750. eCollection 2018.
Neuromuscular blockade is a risk factor for postoperative respiratory weakness during the immediate postoperative period. The quantitative relationships between postoperative pulmonary-function impairment and residual neuromuscular blockade are unknown.
113 patients who underwent elective laparoscopic cholecystectomy were enrolled in this study. They all had a pulmonary-function test (PFT) during the preoperative evaluation. Predictive values based on demographic data were also recorded. The train-of-four ratio (TOFR) was recorded at the same time as the PFT and at every 5 minutes in the qualified 98 patients in the postanesthesia care unit (PACU). We analyzed the degree of PFT recovery when the TOFR had recovered to different degrees.
There was a significant difference ( < 0.05) between the preoperative baseline value and the postoperative forced vital capacity at each TOFR point, except at a TOFR value of 1.1. There was also a significant difference ( < 0.05) between the preoperative baseline value and the postoperative peak expiratory flow at each TOFR point.
Postoperative residual neuromuscular blockade was common (75.51%) after tracheal extubation, and pulmonary function could not recover to an acceptable level (85% of baseline value), even if TOFR had recovered to 0.90.
Chinese Clinical Trial Register is ChiCTR-OOC-15005838.
神经肌肉阻滞是术后即刻呼吸肌无力的一个危险因素。术后肺功能损害与残余神经肌肉阻滞之间的定量关系尚不清楚。
本研究纳入了 113 例行择期腹腔镜胆囊切除术的患者。所有患者在术前评估时均进行了肺功能测试（PFT）。还记录了基于人口统计学数据的预测值。在合格的 98 名患者的麻醉后监护病房（PACU）中，同时记录了四个成串刺激（TOFR）比值和 PFT，并在每 5 分钟记录一次。我们分析了当 TOFR 恢复到不同程度时 PFT 恢复的程度。
除 TOFR 值为 1.1 时外，TOFR 各点的术后用力肺活量与术前基础值之间存在显著差异（<0.05）。TOFR 各点的术后呼气峰流速与术前基础值之间也存在显著差异（<0.05）。
气管拔管后，术后残余神经肌肉阻滞很常见（75.51%），即使 TOFR 恢复到 0.90，肺功能也无法恢复到可接受的水平（基础值的 85%）。
中国临床试验注册中心 ChiCTR-OOC-15005838。
