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Sugammadex versus neostigmine on postoperative pulmonary complications after robot-assisted laparoscopic prostatectomy: a propensity score-matched analysis

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Abstract
Purpose Robot-assisted laparoscopic prostatectomy (RALP) requires particular surgical conditions, such as carbon dioxide pneumoperitoneum and steep Trendelenburg positioning, which may have adverse effects on the respiratory system. The effect of sugammadex on postoperative pulmonary complications (PPCs) is controversial. Therefore, we evaluated the incidence of PPCs according to the type of neuromuscular blockade reversal agents in RALP.

Methods We retrospectively analyzed RALP patients. We compared the incidence of PPCs between patients receiving neostigmine (neostigmine group) and those receiving sugammadex (sugammadex group) as a neuromuscular blockade reversal agent. Propensity score-matched analysis was performed. Other postoperative outcomes, such as duration of hospital stays, major adverse cardiac events during hospital stays, and death during hospital stays, were also compared between the two groups.

Results The incidence of PPCs was 28.9% (137/474) in RALP. The incidence of PPCs was significantly lower in the sugammadex group than in the neostigmine group (18.6% [44/237] vs. 39.2% [93/237], p < 0.001). The incidence of atelectasis was significantly lower in the sugammadex group than in the neostigmine group (18.6% vs. 39.2%, p < 0.001). The incidence of pneumonia was not significantly different between the sugammadex and neostigmine groups after RALP (0.0% vs. 0.4%, p > 0.999). Besides these, other postoperative outcomes were not significantly different between the two groups.

Conclusions The incidence of PPCs after RALP was significantly lower in patients receiving sugammadex than in those receiving neostigmine. These results can provide useful information on the appropriate selection of neuromuscular blockade reversal agents in RALP.
Author(s)
유지현박준영이용수황재현김영국
Issued Date
2021
Type
Article
Keyword
AnesthesiologyComparative analysisCritical Care MedicineEmergency MedicineHumansIntensiveLaparoscopic surgeryLaparoscopyMaleMedicineMedicine &amp; Public HealthNeostigmine - adverse effectsNeuromuscular Blockade - adverse effectsOriginal ArticlePain MedicinePropensity ScoreProstatectomy -adverse effectsRemifentanilRetrospective StudiesRobotic surgeryRoboticsRobotsSugammadex - adverse effects
DOI
10.1007/s00540-021-02910-2
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7268
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_gale_infotracacademiconefile_A656117302&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Sugammadex%20versus%20neostigmine%20on%20postoperative%20pulmonary%20complications%20after%20robot-assisted%20laparoscopic%20prostatectomy:%20a%20propensity%20score-matched%20analysis&amp;offset=0&amp;pcAvailability=true
Publisher
JOURNAL OF ANESTHESIA
Location
일본
Language
영어
ISSN
0913-8668
Citation Volume
35
Citation Number
2
Citation Start Page
262
Citation End Page
269
Appears in Collections:
Medicine > Medicine
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