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Open AccessArticle

Recovery from Anesthesia after Robotic-Assisted Radical Cystectomy: Two Different Reversals of Neuromuscular Blockade

1
Department of Anaesthesiology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
2
Department of Urology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
3
School of Medicine, University Hospital Center “Tor Vergata”, 00133 Rome, Italy
4
IRCrES, Research Institute on Sustainable Economic Growth of the National Research Council of Italy, 00185 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(11), 1774; https://doi.org/10.3390/jcm8111774
Received: 22 September 2019 / Revised: 21 October 2019 / Accepted: 21 October 2019 / Published: 24 October 2019
(This article belongs to the Special Issue Outcomes and Therapeutic Management of Bladder Cancer)
During robot-assisted radical cystectomy (RARC), specific surgical conditions (a steep Trendelenburg position, prolonged pneumoperitoneum, effective myoresolution until the final stages of surgery) can seriously impair the outcomes. The aim of the study was to evaluate the incidence of postoperative nausea and vomiting (PONV) and ileus and the quality of cognitive function at the awakening in two groups of patients undergoing different reversals. In this randomized trial, patients that were American Society of Anesthesiologists physical status (ASA) ≤III candidates for RARC for bladder cancer were randomized into two groups: In the sugammadex (S) group, patients received 2 mg/kg of sugammadex as reversal of neuromuscolar blockade; in the neostigmine (N) group, antagonization was obtained with neostigmine 0.04 mg/kg + atropine 0.02 mg/kg. PONV was evaluated at 30 min, 6 and 24 h after anesthesia. Postoperative cognitive functions and time to resumption of intestinal transit were also investigated. A total of 109 patients were analyzed (54 in the S group and 55 in the N group). The incidence of early PONV was lower in the S group but not statistically significant (S group 25.9% vs. N group 29%; p = 0.711). The Mini-Mental State test mean value was higher in the S group vs. the N group (1 h after surgery: 29.3 (29; 30) vs. 27.6 (27; 30), p = 0.007; 4 h after surgery: 29.5 (30; 30) vs. 28.4 (28; 30), p = 0.05). We did not observe a significant decrease of the PONV after sugammadex administration versus neostigmine use. The Mini-Mental State test mean value was greater in the S group. View Full-Text
Keywords: anesthesia recovery periods; bladder cancer; cognitive impairment; gamma-cyclodextrins; neuromuscular blockade; robotic radical cystectomy anesthesia recovery periods; bladder cancer; cognitive impairment; gamma-cyclodextrins; neuromuscular blockade; robotic radical cystectomy
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MDPI and ACS Style

Claroni, C.; Covotta, M.; Torregiani, G.; Marcelli, M.E.; Tuderti, G.; Simone, G.; Scotto di Uccio, A.; Zinilli, A.; Forastiere, E. Recovery from Anesthesia after Robotic-Assisted Radical Cystectomy: Two Different Reversals of Neuromuscular Blockade. J. Clin. Med. 2019, 8, 1774. https://doi.org/10.3390/jcm8111774

AMA Style

Claroni C, Covotta M, Torregiani G, Marcelli ME, Tuderti G, Simone G, Scotto di Uccio A, Zinilli A, Forastiere E. Recovery from Anesthesia after Robotic-Assisted Radical Cystectomy: Two Different Reversals of Neuromuscular Blockade. Journal of Clinical Medicine. 2019; 8(11):1774. https://doi.org/10.3390/jcm8111774

Chicago/Turabian Style

Claroni, Claudia; Covotta, Marco; Torregiani, Giulia; Marcelli, Maria E.; Tuderti, Gabriele; Simone, Giuseppe; Scotto di Uccio, Alessandra; Zinilli, Antonio; Forastiere, Ester. 2019. "Recovery from Anesthesia after Robotic-Assisted Radical Cystectomy: Two Different Reversals of Neuromuscular Blockade" J. Clin. Med. 8, no. 11: 1774. https://doi.org/10.3390/jcm8111774

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