Key result
Maintaining deep versus moderate neuromuscular block intraoperatively resulted in no cases of myocardial injury after non-cardiac surgery (MINS) within 7 days postoperatively in either group.
Why the study?
MINS is a common and serious complication in elderly patients, prompting investigation into whether the depth of neuromuscular block affects MINS incidence and other cardiovascular complications after laparoscopic colorectal cancer resection.
Does deep neuromuscular block reduce MINS incidence in elderly patients undergoing laparoscopic colorectal cancer resection?
RCT (n=70)
Single-blind
1:1
No
Does deep neuromuscular block reduce MINS incidence in elderly patients undergoing laparoscopic colorectal cancer resection?
Maintaining deep versus moderate neuromuscular block during laparoscopic colorectal cancer resection in elderly patients did not change the incidence of MINS, as no cases were observed in either group.
Answers are grounded in this paper and cite their sources.
Deep vs moderate neuromuscular blockade shows no MINS difference; leaves open whether block depth affects early cardiac risk in elderly colorectal resection.
Background Myocardial injury after non-cardiac surgery (MINS) is a common and serious complication in elderly patients. This study investigates the impact of neuromuscular block on the MINS incidence and other cardiovascular complications in the early postoperative stage of elderly patients undergoing laparoscopic colorectal cancer resection. Methods 70 elderly patients who underwent laparoscopic colorectal cancer resection were separated into the deep neuromuscular block group and moderate neuromuscular block group for 35 cases in each group (n = 1:1). The deep neuromuscular block group maintained train of four (TOF) = 0, post-tetanic count (PTC) 1–2, and the moderate neuromuscular block group maintained TOF = 1–2 during the operation. Sugammadex sodium was used at 2 mg/kg or 4 mg/kg for muscle relaxation antagonism at the end of surgery. Postoperative follow-up was performed to compare MINS incidence and other cardiovascular complications during the first 7 days after surgery. Results MINS were not observed in both groups. The highest incidence of postoperative cardiovascular complications was lower limbs deep vein thrombosis (11.4%). The numeric rating scale score in the deep neuromuscular block group was lower than the moderate neuromuscular block group 72 h after surgery (P = 0.018). The operation time in the deep neuromuscular block group was longer (P = 0.008), the dosage of propofol and remifentanil was less (P = 0.043; P < 0.001), and the length of hospital stay was shorter than the moderate neuromuscular block group (P = 0.028). Conclusions Maintaining different degrees of the neuromuscular block under TOF guidance did not change the MINS incidence within 7 days after surgery in elderly patients who underwent laparoscopic colorectal cancer resection. Trial registration The present study was registered in the Chinese Clinical Trial Registry (10/02/2021, ChiCTR2100043323).
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An et al. (2023) conducted an RCT in Laparoscopic colorectal cancer resection (n=70). Deep neuromuscular block vs. Moderate neuromuscular block (TOF=1-2) was evaluated on Incidence of myocardial injury after non-cardiac surgery (MINS) within 7 days after surgery. Maintaining deep versus moderate neuromuscular block intraoperatively resulted in no cases of myocardial injury after non-cardiac surgery (MINS) within 7 days postoperatively in either group.
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