Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.
Interdepartment of Critical Care Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea.
BMC Anesthesiol. 2020 Jul 21;20(1):178. doi: 10.1186/s12871-020-01088-6.
Sugammadex reduces postoperative complications. We sought to determine whether it could reduce the length of hospital stay, post-anesthetic recovery time, unplanned readmission, and charges for patients who underwent robot-assisted laparoscopic prostatectomy (RALP) when compared to neostigmine.
This was a retrospective observational study of patients who underwent RALP between July 2012 and July 2017, in whom rocuronium was used as a neuromuscular blocker. The primary outcome was the length of hospital stay after surgery in patients who underwent reversal with sugammadex when compared to those who underwent reversal with neostigmine. The secondary outcomes were post-anesthetic recovery time, hospital charges, and unplanned readmission within 30 days after RALP.
In total, 1430 patients were enrolled. Using a generalized linear model in a propensity score-matched cohort, sugammadex use was associated with a 6% decrease in the length of hospital stay (mean: sugammadex 7.7 days vs. neostigmine 8.2 days; odds ratio [OR] 0.94, 95% confidence interval [CI] [0.89, 0.98], P = 0.008) and an 8% decrease in post-anesthetic recovery time (mean: sugammadex 36.7 min vs. neostigmine 40.2 min; OR 0.92, 95% CI [0.90, 0.94], P < 0.001) as compared to neostigmine use; however, it did not reduce the 30-day unplanned readmission rate (P = 0.288). The anesthesia charges were higher in the sugammadex group than in the neostigmine group (P < 0.001); however, there were no significant differences between the groups in terms of postoperative net charges (P = 0.061) and total charges (P = 0.100).
Compared to the reversal of rocuronium effects with neostigmine, reversal with sugammadex after RALP was associated with a shorter hospital stay and post-anesthetic recovery time, and was not associated with 30-day unplanned readmission rates and net charges.
舒更葡糖钠可减少术后并发症。我们旨在确定与新斯的明相比，舒更葡糖钠是否可以降低接受机器人辅助腹腔镜前列腺切除术（RALP）的患者的住院时间、麻醉后恢复时间、非计划性再入院率和费用。
这是一项回顾性观察性研究，纳入了 2012 年 7 月至 2017 年 7 月间接受 RALP 且使用罗库溴铵作为神经肌肉阻滞剂的患者。主要结局是与新斯的明逆转相比，接受舒更葡糖钠逆转的患者术后住院时间。次要结局是麻醉后恢复时间、住院费用和 RALP 后 30 天内的非计划性再入院率。
共纳入 1430 例患者。在倾向评分匹配队列中使用广义线性模型，与新斯的明相比，使用舒更葡糖钠与住院时间缩短 6%相关（平均：舒更葡糖钠组 7.7 天 vs. 新斯的明组 8.2 天；比值比 [OR] 0.94，95%置信区间 [CI] [0.89, 0.98]，P=0.008）和麻醉后恢复时间缩短 8%相关（平均：舒更葡糖钠组 36.7 分钟 vs. 新斯的明组 40.2 分钟；OR 0.92，95% CI [0.90, 0.94]，P<0.001）；然而，它并未降低 30 天内非计划性再入院率（P=0.288）。与新斯的明组相比，舒更葡糖钠组的麻醉费用更高（P<0.001）；然而，两组间术后净费用（P=0.061）和总费用（P=0.100）无显著差异。
与新斯的明逆转罗库溴铵的作用相比，RALP 后使用舒更葡糖钠与住院时间和麻醉后恢复时间缩短相关，与 30 天内非计划性再入院率和净费用无关。
