Eun-Su Choi MD, PhD , Jiyoun Lee MD , Ji Hyeon Lee MD , Jin-Hee Kim MD, PhD , Sung-Hee Han MD, PhD , Jin-Woo Park MD, PhD
{"title":"使用新斯的明/甘氨酰吡咯烷酮逆转神经肌肉阻滞与使用苏加麦司逆转神经肌肉阻滞对腹腔镜结直肠手术后肠蠕动恢复的影响：随机对照试验","authors":"Eun-Su Choi MD, PhD , Jiyoun Lee MD , Ji Hyeon Lee MD , Jin-Hee Kim MD, PhD , Sung-Hee Han MD, PhD , Jin-Woo Park MD, PhD","doi":"10.1016/j.jclinane.2024.111588","DOIUrl":null,"url":null,"abstract":"<div><h3>Study objective</h3><p>To compare the effects of neostigmine/glycopyrrolate (a traditional agent) and sugammadex on bowel motility recovery and the occurrence of digestive system complications after colorectal surgery.</p></div><div><h3>Design</h3><p>Prospective, randomized controlled trial.</p></div><div><h3>Setting</h3><p>A single tertiary center.</p></div><div><h3>Patients</h3><p>111 patients undergoing laparoscopic colorectal surgery.</p></div><div><h3>Interventions</h3><p>Patients were randomized into two groups based on the block reversal agent: 1) a mixture of 50 μg.kg<sup>−1</sup> of neostigmine and 10 μg.kg-1 of glycopyrrolate (neostigmine group) and 2) 2 mg.kg<sup>−1</sup> of sugammadex (sugammadex group).</p></div><div><h3>Measurements</h3><p>The primary outcome was the time from the surgery's completion to the first flatus.</p><p>The time to the first postoperative defecation, incidences of postoperative nausea or vomiting, ileus, and dry mouth, as well as postoperative length of stay, were also assessed.</p></div><div><h3>Main results</h3><p>The time to the first flatus was significantly shorter in the sugammadex group than in the neostigmine group (59 [42–79] h vs 69 [53–90] h, <em>P</em> = 0.027). The time to the first defecation and the incidences of postoperative nausea or vomiting and ileus did not differ between the groups, nor did the postoperative length of stay. However, the incidence of postoperative dry mouth was significantly lower in the sugammadex group than in the neostigmine group (7 patients [13%] vs 39 patients [71%], <em>P</em> < 0.001).</p></div><div><h3>Conclusions</h3><p>The time to the first flatus was shorter using 2 mg.kg<sup>−1</sup> sugammadex to reverse the neuromuscular block for laparoscopic colorectal surgery compared to reversal with conventional neostigmine/glycopyrrolate.</p></div>","PeriodicalId":15506,"journal":{"name":"Journal of Clinical Anesthesia","volume":"98 ","pages":"Article 111588"},"PeriodicalIF":5.0000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of neuromuscular block reversal with neostigmine/glycopyrrolate versus sugammadex on bowel motility recovery after laparoscopic colorectal surgery: A randomized controlled trial\",\"authors\":\"Eun-Su Choi MD, PhD , Jiyoun Lee MD , Ji Hyeon Lee MD , Jin-Hee Kim MD, PhD , Sung-Hee Han MD, PhD , Jin-Woo Park MD, PhD\",\"doi\":\"10.1016/j.jclinane.2024.111588\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Study objective</h3><p>To compare the effects of neostigmine/glycopyrrolate (a traditional agent) and sugammadex on bowel motility recovery and the occurrence of digestive system complications after colorectal surgery.</p></div><div><h3>Design</h3><p>Prospective, randomized controlled trial.</p></div><div><h3>Setting</h3><p>A single tertiary center.</p></div><div><h3>Patients</h3><p>111 patients undergoing laparoscopic colorectal surgery.</p></div><div><h3>Interventions</h3><p>Patients were randomized into two groups based on the block reversal agent: 1) a mixture of 50 μg.kg<sup>−1</sup> of neostigmine and 10 μg.kg-1 of glycopyrrolate (neostigmine group) and 2) 2 mg.kg<sup>−1</sup> of sugammadex (sugammadex group).</p></div><div><h3>Measurements</h3><p>The primary outcome was the time from the surgery's completion to the first flatus.</p><p>The time to the first postoperative defecation, incidences of postoperative nausea or vomiting, ileus, and dry mouth, as well as postoperative length of stay, were also assessed.</p></div><div><h3>Main results</h3><p>The time to the first flatus was significantly shorter in the sugammadex group than in the neostigmine group (59 [42–79] h vs 69 [53–90] h, <em>P</em> = 0.027). The time to the first defecation and the incidences of postoperative nausea or vomiting and ileus did not differ between the groups, nor did the postoperative length of stay. However, the incidence of postoperative dry mouth was significantly lower in the sugammadex group than in the neostigmine group (7 patients [13%] vs 39 patients [71%], <em>P</em> < 0.001).</p></div><div><h3>Conclusions</h3><p>The time to the first flatus was shorter using 2 mg.kg<sup>−1</sup> sugammadex to reverse the neuromuscular block for laparoscopic colorectal surgery compared to reversal with conventional neostigmine/glycopyrrolate.</p></div>\",\"PeriodicalId\":15506,\"journal\":{\"name\":\"Journal of Clinical Anesthesia\",\"volume\":\"98 \",\"pages\":\"Article 111588\"},\"PeriodicalIF\":5.0000,\"publicationDate\":\"2024-08-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Anesthesia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0952818024002174\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Anesthesia","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0952818024002174","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
研究目的比较新斯的明/甘氨酰吡咯烷酮（一种传统药物）和苏加麦考酚酯对结直肠手术后肠蠕动恢复和消化系统并发症发生的影响.设计前瞻性随机对照试验.设置一个单一的三级中心.患者111名接受腹腔镜结直肠手术的患者.干预根据阻滞逆转剂将患者随机分为两组：1）50 μg.kg-1新斯的明和10 μg.kg-1甘氨酰吡咯烷酮的混合物（新斯的明组）；2）2 mg.kg-1苏加麦考酚酯（苏加麦考酚酯组）.测量主要结果是从手术开始到肠蠕动恢复的时间。测量主要结果是从手术完成到首次排气的时间。主要结果术后首次排便的时间、术后恶心或呕吐、回肠梗阻和口干的发生率以及术后住院时间也进行了评估。主要结果苏格玛迪斯组首次排便的时间明显短于新斯的明组（59 [42-79] h vs 69 [53-90] h，P = 0.027）。两组患者首次排便的时间以及术后恶心或呕吐和回肠梗阻的发生率没有差异，术后住院时间也没有差异。结论在腹腔镜结直肠手术中使用 2 mg.kg-1 苏加麦克斯逆转神经肌肉阻滞与使用传统的新斯的明/甘珀酸逆转相比，首次排便时间更短。
Effects of neuromuscular block reversal with neostigmine/glycopyrrolate versus sugammadex on bowel motility recovery after laparoscopic colorectal surgery: A randomized controlled trial
Study objective
To compare the effects of neostigmine/glycopyrrolate (a traditional agent) and sugammadex on bowel motility recovery and the occurrence of digestive system complications after colorectal surgery.
Patients were randomized into two groups based on the block reversal agent: 1) a mixture of 50 μg.kg−1 of neostigmine and 10 μg.kg-1 of glycopyrrolate (neostigmine group) and 2) 2 mg.kg−1 of sugammadex (sugammadex group).
Measurements
The primary outcome was the time from the surgery's completion to the first flatus.
The time to the first postoperative defecation, incidences of postoperative nausea or vomiting, ileus, and dry mouth, as well as postoperative length of stay, were also assessed.
Main results
The time to the first flatus was significantly shorter in the sugammadex group than in the neostigmine group (59 [42–79] h vs 69 [53–90] h, P = 0.027). The time to the first defecation and the incidences of postoperative nausea or vomiting and ileus did not differ between the groups, nor did the postoperative length of stay. However, the incidence of postoperative dry mouth was significantly lower in the sugammadex group than in the neostigmine group (7 patients [13%] vs 39 patients [71%], P < 0.001).
Conclusions
The time to the first flatus was shorter using 2 mg.kg−1 sugammadex to reverse the neuromuscular block for laparoscopic colorectal surgery compared to reversal with conventional neostigmine/glycopyrrolate.
期刊介绍：
The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained.
The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
