The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial.
<h4>Background</h4>This study aimed to determine whether continuous deep neuromuscular blockade (NMB) improves the surgical conditions and facilitates robotic-assisted laparoscopic radical prostatectomy (RALRP) under low intra-abdominal pressure (IAP) to attenuate the increase in intraoc...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2015-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135412&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849310475207049216 |
|---|---|
| author | Young-Chul Yoo Na Young Kim Seokyung Shin Young Deuk Choi Jung Hwa Hong Chan Yun Kim HeeJoon Park Sun-Joon Bai |
| author_facet | Young-Chul Yoo Na Young Kim Seokyung Shin Young Deuk Choi Jung Hwa Hong Chan Yun Kim HeeJoon Park Sun-Joon Bai |
| author_sort | Young-Chul Yoo |
| collection | DOAJ |
| description | <h4>Background</h4>This study aimed to determine whether continuous deep neuromuscular blockade (NMB) improves the surgical conditions and facilitates robotic-assisted laparoscopic radical prostatectomy (RALRP) under low intra-abdominal pressure (IAP) to attenuate the increase in intraocular pressure (IOP) during CO2 pneumoperitoneum in the steep Trendelenburg (ST) position.<h4>Methods</h4>Sixty-seven patients undergoing RALRP were randomly assigned to a moderate NMB group (Group M), including patients who received atracurium infusion until the end of the ST position, maintaining a train of four count of 1-2; and the deep NMB group (Group D), including patients who received rocuronium infusion, maintaining a post-tetanic count of 1-2. IOP was measured in all patients at nine separate time points. All RALRPs were performed by one surgeon, who rated the overall and worst surgical conditions at the end of the ST position.<h4>Results</h4>The highest IOP value was observed at T4 (60 min after the ST position) in both Group M (23.3 ± 2.7 mmHg) and Group D (19.8 ± 2.1 mmHg). RALRP was accomplished at an IAP of 8 mmHg in 88% Group D patients and 25% Group M patients. The overall surgical condition grade was 4.0 (3.0-5.0) in Group D and 3.0 (2.0-5.0) in Group M (P < 0.001).<h4>Conclusion</h4>The current study demonstrated that continuous deep NMB may improve surgical conditions and facilitate RALRP at a low IAP, resulting in significant attenuation of the increase on IOP. Moreover, low-pressure pneumoperitoneum, facilitated by deep NMB still provided acceptable surgical conditions.<h4>Trial registration</h4>ClinicalTrials.gov NCT02109133. |
| format | Article |
| id | doaj-art-f70f95f65a05440aa41c4cf7d8f2e444 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-f70f95f65a05440aa41c4cf7d8f2e4442025-08-20T03:53:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01108e013541210.1371/journal.pone.0135412The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial.Young-Chul YooNa Young KimSeokyung ShinYoung Deuk ChoiJung Hwa HongChan Yun KimHeeJoon ParkSun-Joon Bai<h4>Background</h4>This study aimed to determine whether continuous deep neuromuscular blockade (NMB) improves the surgical conditions and facilitates robotic-assisted laparoscopic radical prostatectomy (RALRP) under low intra-abdominal pressure (IAP) to attenuate the increase in intraocular pressure (IOP) during CO2 pneumoperitoneum in the steep Trendelenburg (ST) position.<h4>Methods</h4>Sixty-seven patients undergoing RALRP were randomly assigned to a moderate NMB group (Group M), including patients who received atracurium infusion until the end of the ST position, maintaining a train of four count of 1-2; and the deep NMB group (Group D), including patients who received rocuronium infusion, maintaining a post-tetanic count of 1-2. IOP was measured in all patients at nine separate time points. All RALRPs were performed by one surgeon, who rated the overall and worst surgical conditions at the end of the ST position.<h4>Results</h4>The highest IOP value was observed at T4 (60 min after the ST position) in both Group M (23.3 ± 2.7 mmHg) and Group D (19.8 ± 2.1 mmHg). RALRP was accomplished at an IAP of 8 mmHg in 88% Group D patients and 25% Group M patients. The overall surgical condition grade was 4.0 (3.0-5.0) in Group D and 3.0 (2.0-5.0) in Group M (P < 0.001).<h4>Conclusion</h4>The current study demonstrated that continuous deep NMB may improve surgical conditions and facilitate RALRP at a low IAP, resulting in significant attenuation of the increase on IOP. Moreover, low-pressure pneumoperitoneum, facilitated by deep NMB still provided acceptable surgical conditions.<h4>Trial registration</h4>ClinicalTrials.gov NCT02109133.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135412&type=printable |
| spellingShingle | Young-Chul Yoo Na Young Kim Seokyung Shin Young Deuk Choi Jung Hwa Hong Chan Yun Kim HeeJoon Park Sun-Joon Bai The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial. PLoS ONE |
| title | The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial. |
| title_full | The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial. |
| title_fullStr | The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial. |
| title_full_unstemmed | The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial. |
| title_short | The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial. |
| title_sort | intraocular pressure under deep versus moderate neuromuscular blockade during low pressure robot assisted laparoscopic radical prostatectomy in a randomized trial |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135412&type=printable |
| work_keys_str_mv | AT youngchulyoo theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT nayoungkim theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT seokyungshin theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT youngdeukchoi theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT junghwahong theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT chanyunkim theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT heejoonpark theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT sunjoonbai theintraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT youngchulyoo intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT nayoungkim intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT seokyungshin intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT youngdeukchoi intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT junghwahong intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT chanyunkim intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT heejoonpark intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial AT sunjoonbai intraocularpressureunderdeepversusmoderateneuromuscularblockadeduringlowpressurerobotassistedlaparoscopicradicalprostatectomyinarandomizedtrial |