Surgery: Current Research

ISSN - 2161-1076

The effect of deep neuromuscular block on surgical stress response during laparoscopic gastrectomy

Joint Event 7th International Conference and Exhibition on Surgery & 3rd International Conference on Anesthesia

June 21-23, 2018 Dublin, Ireland

Ah-Young Oh, Yea-Ji Lee, Bon-Wook Koo, Hyo-Seok Na, Do-Joong Park and Kwang-Suk Seo

Seoul National University Bundang Hospital, South Korea
Seoul National University, South Korea
Seoul National University Dental Hospital, South Korea

Posters & Accepted Abstracts: Surgery Curr Res

Abstract :

Background: Changes in acute reactive substances of cytokines after surgery are related to the degree of tissue damage and are related to the occurrence of side effects. We evaluated the effect of deep neuromuscular blockade on the responses of inflammatory cytokines following laparoscopic gastrectomy. Method: Patients undergoing elective laparoscopic gastrectomy were randomized to either moderate (train-of-four count of 1 or 2) or deep group (post-tetanic count of 1 or 2). Neuromuscular blockade was induced and maintained with rocuronium that was reversed with sugammadex in the deep group and with neostigmine in the moderate group. Plasma TNF-α, IL-1β, IL-6, IL-8, and CRP were measured before operation and post- incision of 3, 4 and 48 hours. Results: Intraoperative spontaneous breathing (26.7% vs. 4.7%, P=0.005), and request for neuromuscular blockade (75% vs. 47.6%, P=0.015) were more frequent in the moderate group compared to the deep group. There were no statistically significant differences in post-incisional plasma TNF-α, IL-1β, IL-6, IL-8, and CRP between the two groups. Conclusion: In patients undergoing elective laparoscopic gastrectomy, intraoperative conditions were favorable during a deep neuromuscular blockade compared to a moderate neuromuscular blockade. However, the depth of neuromuscular blockade did not affect the release of inflammatory cytokines during laparoscopic gastrectomy.
Recent Publications
1. Choi E S, Oh AY, Koo B W, Hwang J W, Han J W, et al. (2017) Comparison of reversal with neostigmine of low-dose rocuronium vs. reversal with sugammadex of high-dose rocuronium for a short procedure. Anaesthesia. 72:1185�??90.
2. Koo B W, Jung K W, Oh A Y, Kim E Y, Na H S, et al. (2017) Is neuromuscular blocker needed in children undergoing inguinal herniorrhaphy? Medicine 96(26):7259.
3. Koo B W, Oh A Y, Seo K S, Han J W, Han H S, et al. (2016) Randomised clinical trial of moderate versus deep neuromuscular block for low-pressure pneumoperitoneum during laparoscopic cholecystectomy. World J Surg. 16(1):2898�??903.
4. Choi E S, Oh A Y, Seo K S, Hwang J W, Ryu J H, et al. (2016) Optimum dose of neostigmine to reverse shallow neuromuscular blockade with rocuronium and cisatrac-urium. Anaesthesia 71(4):443�??9.
5. Song I A, Seo K S, Oh A Y, No H J, Hwang J W, et al. (2015) Timing of reversal with respect to three nerve stimulator end-points from cisatracurium-induced neuromuscular block. Anaesth. 70(7):797�??802.

Biography :

Ah-Young Oh is an Anesthesiologist, specializing in Pediatric Anesthesia and Anesthesia Pharmacology. She has published articles in international journals regarding pediatric anesthesia, the safety and efficiency of muscle relaxants and inhalational anesthetics, monitoring the level of consciousness during general anesthesia, and postoperative pain management. She graduated from and had a Doctorship at the Seoul National University, College of Medicine.