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Effect of Deep versus Moderate Neuromuscular Blockade on Quantitatively Assessed Postoperative Atelectasis Using Computed Tomography in Thoracic Surgery; a Randomized Double-Blind Controlled Trial
- Source :
- Journal of Clinical Medicine, Vol 10, Iss 3228, p 3228 (2021), Journal of Clinical Medicine
- Publication Year :
- 2021
- Publisher :
- MDPI AG, 2021.
-
Abstract
- Background: postoperative atelectasis is a significant clinical problem during thoracic surgery with one-lung ventilation. Intraoperative deep neuromuscular blockade can improve surgical conditions, but an increased risk of residual paralysis may aggravate postoperative atelectasis. Every patient was verified to have full reversal before extubation. We compared the effect of deep versus moderate neuromuscular blockade on postoperative atelectasis quantitatively using chest computed tomography. Methods: patients undergoing thoracic surgery were randomly allocated to two groups: moderate neuromuscular blockade during surgery (group M) and deep neuromuscular blockade during surgery (group D). The primary outcome was the proportion and the volume of postoperative atelectasis measured by chest computed tomography on postoperative day 2. The mean values of the repeatedly measured intraoperative dynamic lung compliance during surgery were also compared. Result: the proportion of postoperative atelectasis did not differ between the groups (1.32 [0.47–3.20]% in group M and 1.41 [0.24–3.07]% in group D, p = 0.690). The actual atelectasis volume was 38.2 (12.8–61.4) mL in group M and 31.9 (7.84–75.0) mL in group D (p = 0.954). Some factors described in the lung protective ventilation were not taken into account and might explain the atelectasis in both groups. The mean lung compliance during one-lung ventilation was higher in group D (26.6% in group D vs. 24.1% in group M, p = 0.026). Conclusions: intraoperative deep neuromuscular blockade did not affect postoperative atelectasis when compared with moderate neuromuscular blockade if full reversal was verified.
- Subjects :
- medicine.medical_specialty
Atelectasis
Pulmonary compliance
deep block
Article
law.invention
03 medical and health sciences
0302 clinical medicine
neuromuscular blockade
Randomized controlled trial
030202 anesthesiology
law
Postoperative atelectasis
atelectasis
Paralysis
Medicine
Neuromuscular Blockade
business.industry
General Medicine
medicine.disease
Cardiothoracic surgery
Anesthesia
Breathing
postoperative pulmonary complications
medicine.symptom
business
sugammadax
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Volume :
- 10
- Issue :
- 3228
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....6dbc6e1e085fa55578cdbf155d291c01