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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.
J. Clin. Med. 2019, 8(4), 498; https://doi.org/10.3390/jcm8040498
Received: 11 March 2019 / Revised: 2 April 2019 / Accepted: 9 April 2019 / Published: 12 April 2019
(This article belongs to the Section Anesthesiology)
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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MDPI and ACS Style

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. https://doi.org/10.3390/jcm8040498

AMA Style

Oh SK, Kwon W-K, Park S, Ji SG, Kim JH, Park Y-K, Lee SY, Lim BG. 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. Journal of Clinical Medicine. 2019; 8(4):498. https://doi.org/10.3390/jcm8040498

Chicago/Turabian Style

Oh, Seok K., Woo-Keun Kwon, Sangwoo Park, Sul G. Ji, Joo H. Kim, Youn-Kwan Park, Shin Y. Lee, and Byung G. Lim 2019. "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" Journal of Clinical Medicine 8, no. 4: 498. https://doi.org/10.3390/jcm8040498

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