Neuromuscular blockade management and postoperative outcomes in enhanced recovery colorectal surgery: secondary analysis of POWER trial
| Autor: | Oscar Díaz-Cambronero, Javier Longas, Gonzalo Azparren Cabezón, José Antonio García-Erce, Daniel Bordonaba Bosque, Alejandro Suarez de la Rica, Victoriano Soria Aledo, ALBERTO MARTINEZ RUIZ, Javier Ripollés-Melchor, Graciela Martinez-Palli, Francisco Javier Redondo Calvo, Unai De Andres Olabarria, Ane Abad-Motos, Manuel Diez Alonso, Manuel Ángel Gómez-Ríos, Jose miguel Marcos-vidal, José Ignacio Alonso-Fernández, Juan José Segura-Sampedro |
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| Rok vydání: | 2021 |
| Předmět: |
Univariate analysis
Neuromuscular Blockade medicine.medical_specialty business.industry 030208 emergency & critical care medicine Neostigmine Sugammadex Colorectal surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine Enhanced recovery 030202 anesthesiology Secondary analysis Anesthesia medicine Humans Postoperative Period business Colorectal Surgery Surgical patients medicine.drug |
| Zdroj: | Minerva Anestesiologica. 87 |
| ISSN: | 1827-1596 0375-9393 |
| DOI: | 10.23736/s0375-9393.20.14589-9 |
| 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. Neostigmine reversal seems to be linked to higher rate of mortality than sugammadex. |
| Databáze: | OpenAIRE |
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