ABSTRACT
BACKGROUND: This study investigated the effect of pneumoperitoneum on the recovery from intense neuromuscular blockade by rocuronium in healthy patients undergoing laparoscopic abdominal surgery. METHODS: Thirty adult patients undergoing laparoscopic abdominal surgery were studied. Anesthesia was induced with 1.5 mg/kg of propofol, 12 ug/kg of alfentanil and 0.6 mg/kg of rocuronium and maintained with 2 vol% of sevoflurane and 0.05-0.2 microg/kg/min remifentanil. The neuromuscular relaxation was monitored by Train-of-Four (TOF) and post-tetanic count (PTC). Additional rocuronium of 0.2 mg/kg was administered for deep neuromuscular blockade at 30 min after pneumoperitoneum. Before (PPpre) and 30 min after pneumoperitoneum (PPpost), PTC was measured at 6 min intervals. The relationship between PTC and the time interval to reappearance of T1 response was observed. RESULTS: The mean +/- SD of the intervals between the detection of 4 counts of the PTC and the first response to TOF stimulation was 13.0 +/- 1.1 min and 16.4 +/- 6.3 min PPpre and PPpost, respectively (P = 0.20). There were significant negative relationships between PTC observed and the time interval to reappearance of T1 response (adjusted R2 = 0.869, P < 0.001 for PPpre data, and adjusted R2 = 0.561, P < 0.001 for PPpost data). Comparing the difference of regression equation between PPpre and PPpost data using a parallelism test, there was no statistically significant difference (P = 0.193). CONCLUSIONS: This study showed that PP with intra-abdominal pressure at the level of 13-14 mmHg did not affect the recovery from intense neuromuscular blockade by rocuronium in healthy patients undergoing laparoscopic abdominal surgery.
Subject(s)
Adult , Humans , Alfentanil , Anesthesia , Laparoscopy , Neuromuscular Blockade , Neuromuscular Monitoring , Pneumoperitoneum , Propofol , RelaxationABSTRACT
Lymphangioleiomyomatosis (LAM) is a rare, progressive cystic lung disease, characterized by a proliferation of immature smooth muscle cell (LAM cell) in the airway, parenchyma, lymph nodes and pulmonary vessels. It mainly affects women in their reproductive years. It is clinically manifested by recurrent pneumothorax, progressive dyspnea on exertion and chylothorax; it can also ultimately lead to respiratory failure. However, no curative treatment for LAM is currently available. We report an anesthetic management for cesarean delivery in a parturient newly diagnosed with LAM.
Subject(s)
Female , Humans , Anesthesia , Chylothorax , Dyspnea , Lipopolysaccharides , Lung Diseases , Lymph Nodes , Lymphangioleiomyomatosis , Myocytes, Smooth Muscle , Pneumothorax , Respiratory InsufficiencyABSTRACT
Lymphangioleiomyomatosis (LAM) is a rare, progressive cystic lung disease, characterized by a proliferation of immature smooth muscle cell (LAM cell) in the airway, parenchyma, lymph nodes and pulmonary vessels. It mainly affects women in their reproductive years. It is clinically manifested by recurrent pneumothorax, progressive dyspnea on exertion and chylothorax; it can also ultimately lead to respiratory failure. However, no curative treatment for LAM is currently available. We report an anesthetic management for cesarean delivery in a parturient newly diagnosed with LAM.