分析 sugammadex 与腹部手术患者住院时间长度的关联：一项回顾性研究。
Analysis of the association of sugammadex with the length of hospital stay in patients undergoing abdominal surgery: a retrospective study.
机构信息
Department of Anesthesiology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, 42 Baizi Pavilion, Nanjing, Jiangsu Province, China.
Department of Endocrine, Nanjing Hospital of Traditional Chinese Medicine, 157 Daming Road, Nanjing, Jiangsu Province, China.
出版信息
BMC Anesthesiol. 2023 Jan 25;23(1):32. doi: 10.1186/s12871-023-01979-4.
BACKGROUND
Sugammadex is a newer medication used for rapid and reliable reversal of neuromuscular blockade. This study evaluated whether sugammadex could reduce the length of postoperative hospital stay in patients undergoing abdominal surgery.
METHODS
This single center retrospective cohort study included patients who underwent major abdominal surgery between January 2015 and October 2019. Patients were randomized according to reversal with sugammadex or spontaneous recovery. The primary outcome was length of postoperative hospital stay. The secondary outcomes were length of post-anesthetic care unit (PACU) stay, postoperative ambulation time, time-to-first-defecation, and incidence of pulmonary complications. After 1:1 propensity score matching, univariate and multiple linear regression analyses estimated the differences in outcomes.
RESULTS
Of the 1614 patients, 517 received sugammadex and 645 spontaneously recovered. After adjusting for potential confounders, non-linear relationship was detected between administration of sugammadex and the length of postoperative hospital stay (β = 0.29 95% confidence interval {CI}: [- 1.13, - 0.54], P = 0.4912). However, it was associated with shorter PACU stay (β = - 20.30 95% CI: [- 24.48, - 17.11], P < 0.0001), shorter time to postoperative ambulation movement (β = - 0.43 95% CI: [- 0.62, - 0.23], P < 0.0001), and reduced time-to-first-defecation (β = - 2.25 95% CI: [- 0.45, - 0.05], P = 0.0129), when compared to the spontaneously recovered group. The incidence of pneumonia in the sugammadex group was significantly lower than that in the spontaneously recovered group (18.6% [44/237] vs. 39.2% [93/237] P < 0.05).
CONCLUSIONS
Neuromuscular blockade reversal with sugammadex after abdominal surgery demonstrated an excellent recovery profile and was associated with decreased risk of pneumonia, although it did not affect the length of postoperative hospital stay.
背景
舒更葡糖钠是一种新型药物，用于快速可靠地逆转神经肌肉阻滞。本研究评估了舒更葡糖钠是否可以减少腹部手术后患者的住院时间。
方法
这项单中心回顾性队列研究纳入了 2015 年 1 月至 2019 年 10 月期间接受大型腹部手术的患者。患者根据舒更葡糖钠逆转或自发恢复进行随机分组。主要结局是术后住院时间。次要结局是麻醉后监护室（PACU）停留时间、术后活动时间、首次排便时间和肺部并发症发生率。经过 1:1 倾向评分匹配后，单变量和多变量线性回归分析估计了结局的差异。
结果
在 1614 名患者中，517 名接受了舒更葡糖钠治疗，645 名患者自发恢复。在调整了潜在混杂因素后，舒更葡糖钠的使用与术后住院时间之间存在非线性关系（β=0.29，95%置信区间[-1.13，-0.54]，P=0.4912）。然而，它与 PACU 停留时间较短相关（β=-20.30，95%置信区间[-24.48，-17.11]，P<0.0001）、术后活动时间较短（β=-0.43，95%置信区间[-0.62，-0.23]，P<0.0001）和首次排便时间较短（β=-2.25，95%置信区间[-0.45，-0.05]，P=0.0129），与自发恢复组相比。与自发恢复组相比，舒更葡糖钠组肺炎发生率明显较低（18.6%[44/237] vs. 39.2%[93/237]，P<0.05）。
结论
腹部手术后使用舒更葡糖钠逆转神经肌肉阻滞表现出良好的恢复特征，与肺炎风险降低相关，尽管它对术后住院时间没有影响。
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