The Association Between Intraoperative Objective Neuromuscular Monitoring and Rocuronium Consumption During Laparoscopic Abdominal Surgery: A Single-Center Retrospective Analysis (腹腔鏡下腹部手術における筋弛緩モニター使用の有無とロクロニウム投与量の関連性を調べた研究:単一施設後ろ向き研究)
著者
鷹架, 健一
(Takahoko, Kenichi)
上位タイトル
Cureus
Vol.13,
No.11
(2021.
11)
,p.e19245-
識別番号
ISSN
2168-8184
DOI
10.7759/cureus.19245
その他
PMID:34900450
博士論文情報
学位授与番号
10107A570
学位授与年月日
2022-03-25
学位名
博士（医学）
学位授与機関
旭川医科大学
抄録
Background Rocuronium consumption with or without intraoperative objective neuromuscular monitoring in clinical settings of unrestricted use of sugammadex and neuromuscular monitoring has not been reported earlier. The study aimed to investigate the association between the use of intraoperative objective neuromuscular monitoring and rocuronium consumption in patients undergoing laparoscopic abdominal surgery. Methods Data were collected by reviewing electronic medical records of patients who received laparoscopic abdominal surgery under general anesthesia with rocuronium and reversal with sugammadex at a university teaching hospital between May 2017 and April 2018. A multivariate linear regression model was developed to compare the amount of rocuronium consumption (mg) per weight (kg) per hour (mg/kg/h) between the group in which intraoperative objective neuromuscular monitoring was used (NMM+ group) and the group in which intraoperative neuromuscular monitoring was not used (NMM- group). Additionally, we performed an interaction test. Results A total of 429 patients were evaluated, with 371 patients (86%) included in the NMM+ group and 58 patients (14%) in the NMM- group. Log-transformed rocuronium consumption between the NMM+ group and NMM- group was not significantly different (back-transformed β coefficients [95% CI]: 1.080 [0.951-1.226]; P = 0.23). Male sex and body mass index (BMI) were independent factors associated with 15% (0.853 [0.788-0.924]; P < 0.001) and 3% (for every 1 kg/m2 increase in BMI) (0.971 [0.963-0.979]; P < 0.001) decrease in intraoperative rocuronium consumption, respectively. A significant interaction was detected only between the use of neuromuscular monitoring and age ≥65 years (β: 0.803 [0.662-0.974]; P = 0.026). Conclusions Although the use of intraoperative objective neuromuscular monitoring was not an individual factor influencing intraoperative rocuronium consumption, this retrospective study demonstrated that the use of intraoperative neuromuscular monitoring reduced rocuronium consumption for approximately 20% of elderly patients (age ≥65 years) undergoing laparoscopic abdominal surgery.
