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J. Clin. Med. 2019, 8(4), 498; https://doi.org/10.3390/jcm8040498

Comparison of Operating Conditions, Postoperative Pain and Recovery, and Overall Satisfaction of Surgeons with Deep vs. No Neuromuscular Blockade for Spinal Surgery under General Anesthesia: A Prospective Randomized Controlled Trial

1
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea
2
Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Korea
3
Department of Anesthesiology and Pain Medicine, Bundang Jesaeng Hospital, Seongnam, Gyeonggi-do 13590, Korea
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 11 March 2019 / Revised: 2 April 2019 / Accepted: 9 April 2019 / Published: 12 April 2019
(This article belongs to the Section Anesthesiology)
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Abstract

We aimed to investigate operating conditions, postoperative pain, and overall satisfaction of surgeons using deep neuromuscular blockade (NMB) vs. no NMB in patients undergoing lumbar spinal surgery under general anesthesia. Eighty-three patients undergoing lumbar fusion were randomly assigned to receive deep NMB (n = 43) or no NMB (n = 40). In the deep-NMB group, rocuronium was administered to maintain deep NMB (train-of-four count 0, post-tetanic count 1–2) until the end of surgery. In the no-NMB group, sugammadex 4 mg/kg at train-of-four (TOF) count 0–1 or sugammadex 2 mg/kg at TOF count ≥2 was administered to reverse the NMB 10 min after placing the patient prone. Peak inspiratory airway pressure, plateau airway pressure, lumbar retractor pressure significantly were lower in the deep-NMB group. Degree of surgical field bleeding (0–5), muscle tone (1–3), and satisfaction (1–10) rated by the surgeon were all superior in the deep-NMB group. Pain scores, rescue fentanyl consumption in post-anesthesia care unit (PACU), and postoperative patient-controlled analgesia consumption were significantly lower in the deep-NMB group, and this group had a shorter length of stay in PACU. Compared to no NMB, deep NMB provides better operating conditions, reduced postoperative pain and higher overall satisfaction in lumbar spinal surgery. View Full-Text
Keywords: neuromuscular blockade; neuromuscular monitoring; neurosurgical procedures neuromuscular blockade; neuromuscular monitoring; neurosurgical procedures
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Oh, S.K.; Kwon, W.-K.; Park, S.; Ji, S.G.; Kim, J.H.; Park, Y.-K.; Lee, S.Y.; Lim, B.G. Comparison of Operating Conditions, Postoperative Pain and Recovery, and Overall Satisfaction of Surgeons with Deep vs. No Neuromuscular Blockade for Spinal Surgery under General Anesthesia: A Prospective Randomized Controlled Trial. J. Clin. Med. 2019, 8, 498.

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