Department of Anesthesia, The Second Affiliated Hospital of Soochow University, No. 1055, Sanxiang Road, Suzhou, 215004, China.
Department of Anesthesiology of Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, 200030, China.
J Cardiothorac Surg. 2022 Aug 26;17(1):211. doi: 10.1186/s13019-022-01936-1.
There is a growing interest in minimally invasive left atrial appendage closure therapies. However, for successful catheter surgery, it is necessary to achieve high-quality postoperative recovery. The aim of the study is to comparison of neuromuscular blockade and reversal using cisatricurium and neostigmine with rocuronium and sugamadex on the quality of recovery from general anaesthesia for percutaneous closure of left atria appendage.
Eighty-four patients who received percutaneous LAAC were randomly placed into two groups, general anesthesia and endotracheal intubation with either propofol-remifentanil-cisatracurium-neostigmine (group C) or propofol-remifentanil-rocuronium-sugammadex (group S). The QoR-40 questionnaire was used to assess recovery quality 6 h after surgery, and the time of spontaneous respiration, the time of consciousness recovery, the time of extubation, the duration in the postanaesthesia care unit (PACU), and the adverse events after awakening were collected.
Compared with the group C, the group S demonstrated significantly higher individual QoR-40 dimension scores, a significantly shorter recovery time for spontaneous respiration and consciousness, time of extubation, and duration in the PACU, and a lower incidence of transient hypoxemia, agitation, nausea and vomiting and urinary retention. There was a non-significant trend for the length of stay in the hospital in both groups.
General anesthesia and endotracheal intubation with propofol-remifentanil-rocuronium-sugammadex provided better quality of recovery, shorter anaesthesia duration, and lower incidence of hypoxemia and agitation. Neuromuscular blockade and reversal using rocuronium and sugamadex is better than with cisatricurium and neostigmine on the quality of recovery from general anaesthesia for percutaneous closure of left atria appendage.
chictr.org, ChiCTR2000031857. Registered on April 12, 2020.
微创左心耳封堵治疗越来越受到关注。然而，为了成功进行导管手术，需要实现高质量的术后恢复。本研究旨在比较顺式阿曲库铵和新斯的明与罗库溴铵和琥珀酸舒马曲坦用于经皮左心耳封堵全麻后恢复质量的差异。
84 例行经皮 LAAC 的患者随机分为两组，全身麻醉和气管插管，分别采用丙泊酚-瑞芬太尼-顺式阿曲库铵-新斯的明（C 组）或丙泊酚-瑞芬太尼-罗库溴铵-琥珀酸舒马曲坦（S 组）。术后 6 小时采用 QoR-40 问卷评估恢复质量，记录自主呼吸恢复时间、意识恢复时间、拔管时间、麻醉后监护病房（PACU）停留时间和苏醒后不良反应。
与 C 组相比，S 组 QoR-40 各维度评分较高，自主呼吸和意识恢复时间、拔管时间和 PACU 停留时间较短，一过性低氧血症、躁动、恶心呕吐和尿潴留发生率较低。两组患者的住院时间均有缩短趋势，但无统计学意义。
丙泊酚-瑞芬太尼-罗库溴铵-琥珀酸舒马曲坦全身麻醉和气管插管可提供更好的恢复质量，缩短麻醉时间，降低低氧血症和躁动的发生率。与顺式阿曲库铵和新斯的明相比，罗库溴铵和琥珀酸舒马曲坦用于经皮左心耳封堵全麻后的恢复质量更好。
chictr.org，ChiCTR2000031857。于 2020 年 4 月 12 日注册。
