新辅助化疗对sugammadex用于卵巢癌患者神经肌肉阻滞逆转疗效的影响:一项前瞻性队列研究。

IF 5.1 2区 医学 Q1 ANESTHESIOLOGY
Xi Huang , Xiaolan Gu , Lingxi Xing , Qinyu Bao , Rong Gao , Lianbing Gu
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引用次数: 0

摘要

研究目的:探讨新辅助化疗(NAC)对sugammadex用于卵巢癌患者神经肌肉阻滞逆转疗效的影响。设计:这是一项前瞻性队列研究。地点:一所大学附属教学医院的手术室、麻醉后护理病房(PACU)和病房。患者:43例行细胞减缩手术的患者中,21例患者接受了3 ~ 6个周期的NAC联合紫杉醇和卡铂治疗,归为“化疗组”,22例患者术前未接受NAC治疗,归为“非化疗组”。干预措施:术中根据神经肌肉阻滞定量监测结果,给予罗库溴铵间歇注射。手术后,患者被转移到PACU。在四组刺激(T2)中再次出现第二次抽搐反应时,化疗组和非化疗组均给予静脉注射剂量为2mg /kg的糖胺酮,以逆转罗库溴铵诱导的神经肌肉阻滞。测量:研究的主要终点是从给药到四组训练比(TOFr)≥0.9的时间。次要观察指标包括:发病时间、临床持续时间、恢复指数、拔管时间、PACU停留时间、罗库溴铵平均剂量。主要结果:给药后,化疗组TOFr≥0.9的时间较非化疗组延长(5.87±2.20 vs 3.22±1.34 min, p -1·min-1, p = 0.002);两组PACU停留时间差异无统计学意义。结论:研究表明,接受NAC的患者,从给药到TOFr≥0.9的时间、恢复指数、拔管时间均延长。此外,这些患者的发病时间延长,临床持续时间缩短,罗库溴铵的平均剂量增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of neoadjuvant chemotherapy on the efficacy of sugammadex for neuromuscular block reversal in ovarian cancer patients: A prospective cohort study

Study objective

To investigate the impact of neoadjuvant chemotherapy (NAC) on the efficacy of sugammadex for neuromuscular block reversal in ovarian cancer patients.

Design

This is a prospective cohort study.

Setting

Operating room, post-anesthesia care unit (PACU), and wards of a university-affiliated teaching hospital.

Patients

Among the 43 patients who underwent cytoreductive surgery, 21 patients received 3 to 6 cycles of NAC with paclitaxel and carboplatin and were classified as the “Chemo group”, while 22 patients did not receive NAC before surgery and were classified as the “Non-chemo group”.

Intervention

During the surgery, intermittent injections of rocuronium were given based on the quantitative monitoring results of neuromuscular block. After the surgery, the patient was transferred to the PACU. Upon the reappearance of the second twitch response in train-of-four stimulation (T2), both Chemo group and Non-chemo group were given an intravenous dose of 2 mg/kg of sugammadex to reverse the rocuronium-induced neuromuscular block.

Measurements

The primary outcome of the study is the time from sugammadex administration to train-of-four ratio (TOFr) ≥ 0.9. The secondary outcomes include: onset time, clinical duration, recovery index, extubation time, duration of PACU stay, the average dosage of rocuronium.

Main results

After the administration of sugammadex, the time to TOFr ≥0.9 was longer in Chemo group compared to Non-chemo group(5.87 ± 2.20 vs 3.22 ± 1.34 min, p < 0.001). The recovery index [2.25 (1.38, 3.00) vs 1.38 (0.75, 2.06) min, p = 0.020] and extubation time [7.50 (5.34, 10.22) vs 4.45 (4.83, 6.61) min, p = 0.002] were also longer in Chemo group. In the Chemo group, the onset time [2.5 (2.0, 4.75) vs 1.75 (1.44, 2.31) min, p = 0.001] was prolonged, the clinical duration [(39.29 ± 10.29 vs 46.23 ± 5.91 min, p = 0.011)] was shortened, and the average dosage of rocuronium (10.35 ± 2.27 vs 8.51 ± 0.69 μg·kg−1·min−1, P = 0.002) was increased compared to Non-chemo group. There was no significant difference in the duration of PACU stay between the two groups.

Conclusion

The study indicated that in patients who underwent NAC, the time from sugammadex administration to TOFr ≥0.9, the recovery index, and the extubation time were prolonged. Additionally, these patients experienced an textended onset time, a shortened clinical duration, and an increased average dosage of rocuronium.
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来源期刊
CiteScore
7.40
自引率
4.50%
发文量
346
审稿时长
23 days
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.
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