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Article: Effects of residual paralysis after a single intubating dose of rocuronium on postoperative pulmonary function of patients undergoing laparoscopic gynecological surgeries

TitleEffects of residual paralysis after a single intubating dose of rocuronium on postoperative pulmonary function of patients undergoing laparoscopic gynecological surgeries
Authors
KeywordsPostoperative pulmonary function
Residual paralysis
Rocuronium
Issue Date2010
Publisher中国医学科学院. The Journal's web site is located at http://med.wanfangdata.com.cn/Journal/zgyxkxyxb.aspx
Citation
Acta Academiae Medicinae Sinicae, 2010, v. 32 n. 1, p. 103-107 How to Cite?
AbstractObjective: To evaluate the residual paralysis after a single intubating dose of rocuronium and its effect of residual paralysis after a single dose of rocuronium on the postoperative pulmonary function of patients undergoing laparoscopic gynecological surgeries. Methods: Sixty American Society of Anesthesiologists (ASA) I-II patients undergoing laparoscopic gynecological surgeries were randomly divided into rocuronium (R) group (n = 30) and rocuronium + neostigmine (R + N) group (n = 30). All patients received midazolam (0.02 mg/kg), fentanyl (1 μg/kg), propofol (1.5-2 mg/kg), and rocuronium (0.6 mg/kg) to facilitate tracheal intubation and no more relaxant thereafter. Anesthesia was maintained with isoflurane and nitrous oxide in oxygen (N 2O:O2 = 1:1). At the end of the procedure, neuromuscular blockade was not reversed in R group, while antagonism was accomplished with neostigmine (0.04 mg/kg) and atropine (0.02 mg/kg) in R + N group. Immediately after tracheal extubation and on arrival in the PACU, the train-of-four (TOF) ratio at the adductor pollicis of all patients were measured using acceleromyography. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow rate (PEFR) of all patients were measured using spirometry before surgery, after administration of midazolam and fentanyl, immediately after tracheal extubation, on arrival in the PACU, and after the TOF ratio recovered to 1.0. The TOF ratio and pulmonary function between two groups were compared. Results: Immediately after tracheal extubation and on arrival in the PACU, the mean TOF ratio in R group was significantly lower than that in R + N group (P < 0.05). The mean time to achieve TOF ratio of 0.9 and 1.0 in R group was significantly longer than in R + N group (P < 0.05). Immediately after tracheal extubation and on arrival in the PACU, FVC, FEV1, and PEFR were significantly lower in R group than in R + N group (P < 0.05). FVC, FEV1, and PEFR after administration of midazolam and fentanyl and after TOF ratio recovered to 1.0 were significantly lower than the baseline values in all patients (P < 0.01). Conclusions: After a single intubating dose of rocuronium, residual paralysis exists in the majority of patients undergoing laparoscopic gynecological surgeries. The pulmonary function is impaired after the surgery, even after recovery of TOF ratio to 1.0.
Persistent Identifierhttp://hdl.handle.net/10722/132827
ISSN
2015 SCImago Journal Rankings: 0.151
References

 

DC FieldValueLanguage
dc.contributor.authorBai, YHen_HK
dc.contributor.authorRen, HZen_HK
dc.contributor.authorLuo, ALen_HK
dc.contributor.authorHuang, YGen_HK
dc.contributor.authorYe, THen_HK
dc.contributor.authorGuo, XYen_HK
dc.date.accessioned2011-03-29T08:22:03Z-
dc.date.available2011-03-29T08:22:03Z-
dc.date.issued2010en_HK
dc.identifier.citationActa Academiae Medicinae Sinicae, 2010, v. 32 n. 1, p. 103-107en_HK
dc.identifier.issn1000-503Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/132827-
dc.description.abstractObjective: To evaluate the residual paralysis after a single intubating dose of rocuronium and its effect of residual paralysis after a single dose of rocuronium on the postoperative pulmonary function of patients undergoing laparoscopic gynecological surgeries. Methods: Sixty American Society of Anesthesiologists (ASA) I-II patients undergoing laparoscopic gynecological surgeries were randomly divided into rocuronium (R) group (n = 30) and rocuronium + neostigmine (R + N) group (n = 30). All patients received midazolam (0.02 mg/kg), fentanyl (1 μg/kg), propofol (1.5-2 mg/kg), and rocuronium (0.6 mg/kg) to facilitate tracheal intubation and no more relaxant thereafter. Anesthesia was maintained with isoflurane and nitrous oxide in oxygen (N 2O:O2 = 1:1). At the end of the procedure, neuromuscular blockade was not reversed in R group, while antagonism was accomplished with neostigmine (0.04 mg/kg) and atropine (0.02 mg/kg) in R + N group. Immediately after tracheal extubation and on arrival in the PACU, the train-of-four (TOF) ratio at the adductor pollicis of all patients were measured using acceleromyography. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow rate (PEFR) of all patients were measured using spirometry before surgery, after administration of midazolam and fentanyl, immediately after tracheal extubation, on arrival in the PACU, and after the TOF ratio recovered to 1.0. The TOF ratio and pulmonary function between two groups were compared. Results: Immediately after tracheal extubation and on arrival in the PACU, the mean TOF ratio in R group was significantly lower than that in R + N group (P < 0.05). The mean time to achieve TOF ratio of 0.9 and 1.0 in R group was significantly longer than in R + N group (P < 0.05). Immediately after tracheal extubation and on arrival in the PACU, FVC, FEV1, and PEFR were significantly lower in R group than in R + N group (P < 0.05). FVC, FEV1, and PEFR after administration of midazolam and fentanyl and after TOF ratio recovered to 1.0 were significantly lower than the baseline values in all patients (P < 0.01). Conclusions: After a single intubating dose of rocuronium, residual paralysis exists in the majority of patients undergoing laparoscopic gynecological surgeries. The pulmonary function is impaired after the surgery, even after recovery of TOF ratio to 1.0.en_HK
dc.languageengen_US
dc.publisher中国医学科学院. The Journal's web site is located at http://med.wanfangdata.com.cn/Journal/zgyxkxyxb.aspxen_HK
dc.relation.ispartofActa Academiae Medicinae Sinicaeen_HK
dc.subjectPostoperative pulmonary functionen_HK
dc.subjectResidual paralysisen_HK
dc.subjectRocuroniumen_HK
dc.titleEffects of residual paralysis after a single intubating dose of rocuronium on postoperative pulmonary function of patients undergoing laparoscopic gynecological surgeriesen_HK
dc.typeArticleen_HK
dc.identifier.emailBai, YH: baiyuhe@hku.hken_HK
dc.identifier.authorityBai, YH=rp01453en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.3881/j.issn.1000-503X.2010.01.023en_HK
dc.identifier.scopuseid_2-s2.0-77950462091en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77950462091&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume32en_HK
dc.identifier.issue1en_HK
dc.identifier.spage103en_HK
dc.identifier.epage107en_HK
dc.publisher.placeChinaen_HK
dc.identifier.scopusauthoridBai, YH=36092534600en_HK
dc.identifier.scopusauthoridRen, HZ=12761191000en_HK
dc.identifier.scopusauthoridLuo, AL=7103143273en_HK
dc.identifier.scopusauthoridHuang, YG=7501573356en_HK
dc.identifier.scopusauthoridYe, TH=16685562600en_HK
dc.identifier.scopusauthoridGuo, XY=7404331236en_HK

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