Comparison of the Onset of Action, Maintenance, and Recovery of Three Weight-based Dosing of Cisatracurium in Patients with Morbid Obesity in Laparoscopic Bariatric Surgery: A Randomized Clinical Trial.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL
Faranak Rokhtabnak, Saeed Safari, Soudabeh Djalali Motlagh, Toktam Yavari, Elham Pardis
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引用次数: 0

Abstract

Background: For patients with morbid obesity, different cisatracurium dosage regimens are recommended. This study aimed to compare the onset of action, the sufficiency of neuromuscular blockade during infusion, and the recovery of the three distinct cisatracurium dosage scalars in patients with morbid obesity undergoing laparoscopic bariatric surgery.

Methods: In this randomized clinical trial, 55 patients were scheduled for bariatric surgery at Firoozgar Hospital from March 2020 to August 2021. Using a block randomization method, they were randomly divided into three groups, based on total body weight (TBW group), fat-free mass (FFM group), or ideal body weight (IBW group), to receive a bolus of cisatracurium 0.2 mg/Kg, followed by an infusion of 2 µg/Kg, to maintain a train-of-four (TOF) count≤2. Data were analyzed using SPSS software. P<0.05 was considered statistically significant.

Results: The mean time (seconds) to reach TOF0 in the TBW group was significantly shorter (201.89, 95%CI=192.99-210.79; P=0.004) than the IBW group (233.53, 95%CI=218.71-248.34; P=0.01). However, this difference was not statistically significant between TBW and FFM groups (220.83, 95%CI=199.73-241.94; P=0.81) or between FFM and the IBW groups (P=0.23). The rescue dose and increments of cisatracurium infusion were not required in the TBW group, whereas their probability was 4.81 times higher in the IBW group than the FFM group. Furthermore, the TBW and FFM groups had higher mean surgical condition scores than the IBW group (P<0.001, and P=0.006, respectively).

Conclusion: Cisatracurium loading and infusion dosing based on FFM provide a comparable onset of action and surgical field condition to the TBW-based dosing with a shorter recovery time. However, IBW-based dosing of cisatracurium was insufficient for laparoscopic bariatric surgery.Trial Registration Number: IRCT20151107024909N9.A preprint of this study was published at . doi: .

在腹腔镜减重手术的病态肥胖患者中,比较三种基于体重的顺阿曲库铵剂量的起效、维持和恢复情况:随机临床试验
背景:对于病态肥胖患者,建议采用不同的顺阿曲库铵剂量方案。本研究旨在比较三种不同顺阿曲库铵剂量标度在接受腹腔镜减肥手术的病态肥胖患者中的起效时间、输注过程中神经肌肉阻滞的充分性以及恢复情况:在这项随机临床试验中,55 名患者计划于 2020 年 3 月至 2021 年 8 月在菲罗兹加医院接受减肥手术。根据总重量(TBW 组)、去脂体重(FFM 组)或理想体重(IBW 组),采用分块随机法将他们随机分为三组,分别接受顺阿曲库铵 0.2 毫克/千克的栓注,然后输注 2 微克/千克,以维持四列数(TOF)≤2。数据使用 SPSS 软件进行分析。结果TBW 组达到 TOF0 的平均时间(秒)(201.89,95%CI=192.99-210.79;P=0.004)明显短于 IBW 组(233.53,95%CI=218.71-248.34;P=0.01)。但是,TBW 组和 FFM 组之间(220.83,95%CI=199.73-241.94;P=0.81)或 FFM 组和 IBW 组之间(P=0.23)的差异无统计学意义。TBW 组无需使用顺阿曲库铵,而 IBW 组使用顺阿曲库铵的概率是 FFM 组的 4.81 倍。此外,TBW 组和 FFM 组的平均手术条件评分也高于 IBW 组(结论:TBW 组和 FFM 组的平均手术条件评分高于 IBW 组):基于 FFM 的顺阿曲库铵加载和输注剂量与基于 TBW 的剂量具有相似的起效时间和手术视野条件,且恢复时间更短。然而,基于 IBW 的顺阿曲库铵剂量不足以用于腹腔镜减肥手术。试验登记号:IRCT20151107024909N9.本研究的预印本发表于.doi: .
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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