Deep Neuromuscular Block Affect the Quality of Recovery After Laparoscopic Hysterectomy

Effect of Deep Neuromuscular Block on the Quality of Recovery After Laparoscopic Hysterectomy

BACKGROUND: Some studies have revealed that deep neuromuscular block (NMB) improve surgical conditions and alleviated postoperative pain compared with moderate NMB. The present study investigated deep NMB could improve the quality of recovery after laparoscopic hysterectomy

METHODS: seventy-two women with elective laparoscopic hysterectomy were randomly divided into 2 groups: Patients in group A received low-pressure pneumoperitoneum (LPP), which was set at 8-10 mmHg with deep NMB. Patients in group B received standard-pressure pneumoperitoneum (SPP), which was set at 12-14 mmHg with moderate NMB. Primary outcome was the quality of recovery (QoR-15) at 1 day after sugery. The secondary outcomes included postoperative pain, surgical condition, incidence of shoulder pain, the incidence of rescue analgesic drug use, cumulative dose of analgesics, time of first flatus, post-operative nausea and vomiting, time of tracheal tube removal.

Inclusion Criteria:

• American Society of Anesthesiologists (ASA) physical status Ⅰ- Ⅲ
• Scheduled for elective laparoscopic hysterectomy

Exclusion Criteria:

• Inability to give informed consent
• BMI >35
• Renal or hepatic insufficiency
• History of preoperative psychiatric
• Previous surgery at procedure site
• Neuromuscular disease, pregnancy, and contraindications to study medications.