Han Jiwon, Oh Ah-Young, Jeon Yong-Tae, Koo Bon-Wook, Kim Bo Young, Kim Donghyun, Hwang Insung
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gumi-ro, Bundang-gu, Seongnam-si 13620, Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Daehak-ro, Jongno-gu, Seoul 03080, Korea.
J Clin Med. 2021 Mar 1;10(5):938. doi: 10.3390/jcm10050938.
The risk of neuromuscular blockade is certainly minimized by sugammadex in combination with monitoring. However, the effect of sugammadex-aided recovery on patients' satisfaction is unclear. This study compared the Quality of Recovery (QoR)-15 score, which is a patient-reported outcome, in patients undergoing laparoscopic cholecystectomy. Eighty patients were randomly assigned to the neostigmine or sugammadex groups. At the end of surgery, neostigmine or sugammadex was administered, and tracheal extubation was performed after confirmation of a train of four ratio ≥ 0.9. The QoR-15 questionnaire was administered at 1 day before surgery and on post-operative days (POD) 1 and 2. The primary outcome was the QoR-15 score on POD 1. The secondary outcomes were the QoR-15 score on POD 2, modified Aldrete score, length of post-anesthetic care unit stay, post-operative pain, administration of anti-emetics, urinary retention, and length of hospital stay. No significant differences were found in QoR-15 scores on POD 1 (94.4 vs. 95.5, = 0.87) or 2 (116.3 vs. 122, = 0.33). Secondary outcomes were also comparable, with the exception of urinary retention (15.8% neostigmine vs. 2.6% sugammadex, = 0.04). This study demonstrated that the quality of recovery was comparable between the neostigmine and sugammadex groups when reversal and tracheal extubation were performed in accordance with the current guidelines.
舒更葡糖钠联合监测确实可将神经肌肉阻滞的风险降至最低。然而，舒更葡糖钠辅助恢复对患者满意度的影响尚不清楚。本研究比较了接受腹腔镜胆囊切除术患者的患者报告结局——恢复质量（QoR）-15评分。80例患者被随机分配至新斯的明组或舒更葡糖钠组。手术结束时，给予新斯的明或舒更葡糖钠，并在四个成串刺激比值≥0.9得到确认后进行气管拔管。在手术前1天以及术后第1天和第2天进行QoR-15问卷调查。主要结局是术后第1天的QoR-15评分。次要结局包括术后第2天的QoR-15评分、改良Aldrete评分、麻醉后监护病房停留时间、术后疼痛、止吐药的使用、尿潴留和住院时间。术后第1天（94.4对95.5，P=0.87）或第2天（116.3对122，P=0.33）的QoR-15评分无显著差异。除尿潴留外（新斯的明组为15.8%，舒更葡糖钠组为2.6%，P=0.04），次要结局也具有可比性。本研究表明，当按照现行指南进行逆转和气管拔管时，新斯的明组和舒更葡糖钠组的恢复质量相当。
