Deep neuromuscular block attenuates intra-abdominal pressure and inflammation and improves post-operative cognition in prostate cancer patients following robotic-assisted radical prostatectomy

IF 2.3 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2023-09-23 DOI:10.1002/rcs.2565

Guangjun Hu, Weidong Shao, Zhuo Chen, Bixi Li, Bo Xu

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引用次数: 0

Abstract

Background

Whether neuromuscular block (NMB) affects Intra-abdominal pressure (IAP) and cognition in Prostate cancer (PC) patients with Robotic-assisted laparoscopic radical prostatectomy (RALRP) remains unclear. Here we aimed to compare the effects of deep and moderate NMB on the IAP, inflammation, and cognition.

Methods

The Moderate neuromuscular block (MNMB) group (N = 44) and Deep neuromuscular block (DNMB) group (N = 47) were recruited. Intra-abdominal pressure was adjusted to meet RALRP requirements. The expression of pro-inflammatory factors was measured by ELISA. MMSE scores were recorded before the operation, 1 day and 1 week after the operation.

Results

Significant decreases in IAP (p < 0.001) and IL-1β, IL-6, TNF-a, and S-100β (p ≤ 0.01) expressions were found in the DNMB group. The MMSE score in the DNMB group was higher than that in the MNMB group on day one (p = 0.046). The incidence of nausea and vomiting was lower in the DNMB group than that in the MNMB group (p = 0.013).

Conclusions

DNMB reduces IAP and inflammation and improves post-operative cognitive functions in PC patients with RALRP.

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机器人辅助前列腺癌根治术后，深层神经肌肉阻滞可减轻前列腺癌症患者的腹腔压力和炎症，并改善术后认知。

背景：神经肌肉阻滞（NMB）是否影响机器人辅助腹腔镜前列腺癌根治术（RALRP）前列腺癌症（PC）患者的自主压（IAP）和认知仍不清楚。在这里，我们旨在比较深度和中度NMB对IAP、炎症和认知的影响。方法：采用中度神经肌肉阻滞（MNMB）组（N=44）和深度神经肌肉阻滞组（DNMB）（N=47）。调整腹内压力以满足RALRP要求。通过ELISA测定促炎因子的表达。术前、术后1天和1周记录MMSE评分。结果：IAP显著降低（p结论：DNMB可降低RALRP PC患者的IAP和炎症，改善术后认知功能。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.