Publication: Deep neuromuscular blockade for endolaryngeal procedures: A multicenter randomized study
Issued Date
2020-02-01
Resource Type
ISSN
15314995
0023852X
0023852X
Other identifier(s)
2-s2.0-85064181232
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Mahidol University
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SCOPUS
Bibliographic Citation
Laryngoscope. Vol.130, No.2 (2020), 437-441
Suggested Citation
Prok Laosuwan, Phuriphong Songarj, Worawut Lapisatepun, Settapong Boonsri, Oraluxna Rodanant, Wirat Wasinwong, Wimonrat Sriraj, Jittiya Watcharotayangul, Mingkwan Wongyingsinn Deep neuromuscular blockade for endolaryngeal procedures: A multicenter randomized study. Laryngoscope. Vol.130, No.2 (2020), 437-441. doi:10.1002/lary.27956 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/53773
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Title
Deep neuromuscular blockade for endolaryngeal procedures: A multicenter randomized study
Abstract
© 2019 The American Laryngological, Rhinological and Otological Society, Inc. Objectives/Hypothesis: The aim of the present study was to compare the surgical condition between deep neuromuscular blockade (NMB) and moderate NMB. Study Design: Multicenter, randomized, parallel intervention trial. Methods: One hundred two patients underwent microscopic endolaryngeal surgery at four university hospitals. The patients were randomized into moderate NMB (train-of-four 1-2) (M group) or deep NMB (post-tetanic count 1-2) (D group) with moderate or high doses of rocuronium, respectively. Surgical rating conditions (SRCs) were evaluated during the surgery. Sugammadex was given to the M group at 2 mg/kg and the D group at 4 mg/kg. Perioperative clinical signs and conditions were recorded until discharge from the postanesthesia care unit. Results: Clinically acceptable SRC was observed in 49 patients (100%) in the D group and 43 patients (89.6%) in the M group (P =.027). The frequency of notable vocal fold movement in the M group was significantly higher than the D group (70.8% vs. 32.7%). The patients in the M group required more additional doses of rocuronium (47.9%) than the D group (20.4%) to maintain full relaxation (P =.005). The median time (interquartile range) from administration of sugammadex to train-of-four ratio 0.9 in the D group was shorter than the M group (120 [109–180 minutes] vs. 180 minutes [120–240 minutes], P =.034). Conclusions: Deep NMB with high doses of rocuronium combined with 4 mg/kg of sugammadex for reversal during endolaryngeal surgery provided better SRC and anesthetic conditions than moderate NMB of rocuronium with 2 mg/kg of sugammadex. Level of Evidence: 1b Laryngoscope, 130:437–441, 2020.