Influence of Deep Neuromuscular Blockade on Perioperative Stress Response in Patients Undergoing Robot-Assisted Gastrectomy: A Prospective Double-Blinded Randomized-Controlled Trial

被引：4

作者：

Kim, Myoung Hwa ^{[1
]}

Kim, Na Young ^{[2
]}

Yoo, Young Chul ^{[2
]}

Kong, Hee Jung ^{[2
]}

Lee, Hye Sun ^{[3
]}

Jo, Arim ^{[1
]}

Bai, Sun Joon ^{[2
]}

机构：

[1] Yonsei Univ, Gangnam Severance Hosp, Coll Med, Anesthesia & Pain Res Inst,Dept Anesthesiol & Pai, 211 Eonju Ro, Seoul 06273, South Korea

[2] Yonsei Univ, Anesthesia & Pain Res Inst, Coll Med, Dept Anesthesiol & Pain Med, 50-1 Yonsei Ro, Seoul 03722, South Korea

[3] Yonsei Univ, Coll Med, Biostat Collaborat Unit, Dept Res Affairs, 50-1 Yonsei Ro, Seoul 03722, South Korea

来源：

JOURNAL OF PERSONALIZED MEDICINE | 2021年 / 11卷 / 12期

关键词：

neuromuscular blockade; robotic surgery; stress response; postoperative recovery; AUTONOMIC NERVOUS ACTIVITY; HEART-RATE-VARIABILITY; CORTISOL RESPONSE; INTERLEUKIN-6; SURGERY; PNEUMOPERITONEUM; THERAPY; TRAUMA;

D O I：

10.3390/jpm11121308

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Attenuating the intraoperative stress response is crucial; however, the effect of neuromuscular blockade (NMB) on surgical stress is not completely understood. We aimed to investigate the effects of NMB on the perioperative stress response during robot-assisted gastrectomy. Patients were assigned to the deep or moderate NMB group. Serum cortisol, prolactin, and interleukin-6 (IL-6) levels and natural killer (NK) cell percentage were measured before anesthesia induction, 90 min after pneumoperitoneum, operation end (OPEnd), and postoperative day 1. Additionally, C-reactive protein (CRP) and albumin levels were estimated. Additionally, intraoperative heart rate variability was evaluated. The deep NMB group showed significantly lower levels of low-frequency/high-frequency (HF) ratio at OPEnd compared to the moderate NMB group (1.4 +/- 0.2 vs. 2.2 +/- 0.3, respectively; Bonferroni corrected p = 0.039). Furthermore, HF power in the deep NMB group was significantly higher at OPEnd than that in the moderate NMB group (45.2 +/- 3.6 vs. 33.8 +/- 4.0, respectively; Bonferroni corrected p = 0.044). However, no significant differences in cortisol, prolactin, IL-6, CRP, and albumin levels and NK cell percentage were found between the two groups. The degree of NMB may have similar effects on stress-related biological markers in patients undergoing robot-assisted gastrectomy.

引用

页数：13