Neuromuscular blockade management and postoperative outcomes in enhanced recovery colorectal surgery: secondary analysis of POWER trial

Autor: Serrano A, Diaz-Cambronero O, Melchor-Ripolles J, Abad-Gurumeta A, Ramirez-Rodriguez J, Martinez-Ubieto J, Sanchez-Merchante M, Rodriguez R, Jorda L, Gil-Trujillo S, Cabellos-Olivares M, Bordonaba-Bosque D, Aldecoa C, POWER Grp, POWER Group
Rok vydání: 2021
Předmět:
Zdroj: Minerva Anestesiologica
r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
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ISSN: 0375-9393
Popis: BACKGROUND: We evaluated the impact of neuromuscular blockade (NMB) management, monitoring and reversal on postoperative outcomes in colorectal surgical patients included in an enhanced recovery program. METHODS: We performed a predefined analysis in 2084 patients undergoing elective colorectal surgery who participated in POWER study. We analyzed them for complications, length of hospital stay and mortality. Two groups were defined: 1) monitoring + reversal of the neuromuscular blockade (M+R) group: all patients receiving neuromuscular blockade monitoring plus reversal of it with any drug (neostigmine or sugammadex) were included; and 2) no monitoring nor reversal (noM+noR) group. In this group all the patients who did not receive monitoring and reversal of the neuromuscular blockade were allocated. RESULTS: Multivariate analysis found no statistically significant differences in moderate-severe complications (174 [25.7%] vs. 124 [27.1%]; P=0.607), length of hospital stay (10.8-+/- 11.1 vs. 11.0 +/- 12.6 days; P=0.683) and mortality (6 [0.9%] vs. 5 [1.1%]; P=0.840) between the group receiving optimal neuromuscular management (M+R) and the one did not receive it (noM+noR). Univariate analysis showed patients reversed with neostigmine died more than those reversed with sugammadex (3 [2.7%] vs. 3 [0.5%]; P=0.048). CONCLUSIONS: Our data suggest optimal neuromuscular blockade management in colorectal surgery is not associated with less moderate-severe complications, length of hospital stay or death during postoperative period in an enhanced recovery program. Neostigminc reversal seems to be linked to higher rate of mortality than sugammadcx.
Databáze: OpenAIRE
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