دورية أكاديمية
أعرض في EDS

Influence of variations in arterial PCO2 on surgical conditions during laparoscopic retroperitoneal surgery.

التفاصيل البيبلوغرافية
العنوان: Influence of variations in arterial PCO2 on surgical conditions during laparoscopic retroperitoneal surgery.
المؤلفون: Boon M; Department of Anaesthesiology., Martini C; Department of Anaesthesiology., Hellinga M; Department of Anaesthesiology., Bevers R; Department of Urology, Leiden University Medical Centre, P5-Q, 2300 RC Leiden, The Netherlands., Aarts L; Department of Anaesthesiology., Dahan A; Department of Anaesthesiology a.dahan@lumc.nl.
المصدر: British journal of anaesthesia [Br J Anaesth] 2016 Jul; Vol. 117 (1), pp. 59-65. Date of Electronic Publication: 2016 May 06.
نوع المنشور: Journal Article; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: England NLM ID: 0372541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-6771 (Electronic) Linking ISSN: 00070912 NLM ISO Abbreviation: Br J Anaesth Subsets: MEDLINE
أسماء مطبوعة: Publication: 2018- : [London] : Elsevier
Original Publication: London, Eng. [etc.]
مواضيع طبية MeSH: Anesthesia, General/*mortality , Carbon Dioxide/*blood , Laparoscopy/*methods , Nephrectomy/*methods , Neuromuscular Blockade/*methods , Prostatectomy/*methods, Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Retroperitoneal Space/surgery ; Young Adult
مستخلص: Background: Although deep neuromuscular block (post-tetanic-count 1-2 twitches) improves surgical conditions during laparoscopic retroperitoneal surgery compared with standard block (train-of-four 1-2 twitches), the quality of surgical conditions varies widely, often related to diaphragmatic contractions. Hypocapnia may improve surgical conditions. Therefore we studied the effect of changes in arterial carbon dioxide concentrations on surgical conditions in patients undergoing laparoscopic surgery under general anaesthesia and deep neuromuscular block.
Methods: Forty patients undergoing elective laparoscopic surgery for prostatectomy or nephrectomy received propofol/remifentanil anaesthesia and deep neuromuscular block with rocuronium. Patients were randomized to surgery under hypocapnic or hypercapnic conditions. During surgery, the surgical conditions were evaluated using the 5-point Leiden-Surgical Rating Scale (L-SRS) ranging from 1 (extremely poor conditions) to 5 (optimal conditions) by the surgeon, who was blinded to group.
Results: Mean (sd) arterial carbon dioxide concentrations were 4.5 (0.6) [range: 3.8-5.6] kPa under hypocapnic and 6.9 (0.6) [6.1-8.1] kPa under hypercapnic conditions. The L-SRS did not differ between groups: 4.84 (0.4) [4-5] in hypocapnia and 4.77 (0.4) [3.9-5] in hypercapnia. Ninety-nine percent of ratings were good or excellent irrespective of treatment.
Conclusions: Deep neuromuscular block provides good to optimal surgical conditions in laparoscopic retroperitoneal urological surgery, independent of the level of arterial [Formula: see text].
Clinical Trial Registration: NCT01968447.
(© The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
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فهرسة مساهمة: Keywords: carbon dioxide; hypercapnia; hypocapnia; laparoscopy; nephrectomy; neuromuscular block; prostatectomy; rocuronium; urological surgical procedures
سلسلة جزيئية: ClinicalTrials.gov NCT01968447
المشرفين على المادة: 142M471B3J (Carbon Dioxide)
تواريخ الأحداث: Date Created: 20160508 Date Completed: 20180806 Latest Revision: 20240325
رمز التحديث: 20240325
مُعرف محوري في PubMed: PMC4913396
DOI: 10.1093/bja/aew114
PMID: 27154574
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-6771
DOI:10.1093/bja/aew114