Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trial
Abstract Deep neuromuscular block (NMB) has been increasingly utilized, but its role in reducing intraoperative opioid requirement has yet to be investigated. Surgical pleth index (SPI) quantifies nociception. We investigated the effects of deep NMB on SPI-guided remifentanil administration in lapar...
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| Format: | Article |
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Nature Portfolio
2022-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-23876-5 |
| _version_ | 1798018373353734144 |
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| author | In Kyong Yi Jin-Soo Kim Hoon Hur Do-Gyun Han Ji Eun Kim |
| author_facet | In Kyong Yi Jin-Soo Kim Hoon Hur Do-Gyun Han Ji Eun Kim |
| author_sort | In Kyong Yi |
| collection | DOAJ |
| description | Abstract Deep neuromuscular block (NMB) has been increasingly utilized, but its role in reducing intraoperative opioid requirement has yet to be investigated. Surgical pleth index (SPI) quantifies nociception. We investigated the effects of deep NMB on SPI-guided remifentanil administration in laparoscopic herniorrhaphy. Total 128 patients undergoing laparoscopic inguinal herniorrhaphy were randomly allocated to two groups of NMB: deep (n = 64) and moderate (n = 64). The remifentanil dose was assessed during intubation, from skin incision until CO2 insertion, and pneumoperitoneum. Mean infusion rate of remifentanil during pneumoperitoneum was higher in moderate NMB group than in deep NMB group (0.103 [0.075–0.143] µg/kg/min vs. 0.073 [0.056–0.097] µg/kg/min, p < 0.001). Consequently, median infusion rate of remifentanil during anesthesia was higher in moderate NMB group (0.076 [0.096–0.067] µg/kg/min vs. 0.067 [0.084–0.058] µg/kg/min, p = 0.016). The duration of post-anesthesia care unit stay was longer in the moderate NMB group (40 [30–40] min vs. 30 [30–40] min, p = 0.045). In conclusion, deep NMB reduced the remifentanil requirement compared with moderate NMB in SPI-guided anesthesia for laparoscopic herniorrhaphy. |
| first_indexed | 2024-04-11T16:21:53Z |
| format | Article |
| id | doaj.art-1bbdf944a99d400ba21c15a234e0a066 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T16:21:53Z |
| publishDate | 2022-11-01 |
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| series | Scientific Reports |
| spelling | doaj.art-1bbdf944a99d400ba21c15a234e0a0662022-12-22T04:14:17ZengNature PortfolioScientific Reports2045-23222022-11-011211910.1038/s41598-022-23876-5Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trialIn Kyong Yi0Jin-Soo Kim1Hoon Hur2Do-Gyun Han3Ji Eun Kim4Department of Anesthesiology and Pain Medicine, Ajou University School of MedicineDepartment of Anesthesiology and Pain Medicine, Ajou University School of MedicineDepartment of Surgery, Ajou University School of MedicineDepartment of Anesthesiology and Pain Medicine, Ajou University School of MedicineDepartment of Anesthesiology and Pain Medicine, Ajou University School of MedicineAbstract Deep neuromuscular block (NMB) has been increasingly utilized, but its role in reducing intraoperative opioid requirement has yet to be investigated. Surgical pleth index (SPI) quantifies nociception. We investigated the effects of deep NMB on SPI-guided remifentanil administration in laparoscopic herniorrhaphy. Total 128 patients undergoing laparoscopic inguinal herniorrhaphy were randomly allocated to two groups of NMB: deep (n = 64) and moderate (n = 64). The remifentanil dose was assessed during intubation, from skin incision until CO2 insertion, and pneumoperitoneum. Mean infusion rate of remifentanil during pneumoperitoneum was higher in moderate NMB group than in deep NMB group (0.103 [0.075–0.143] µg/kg/min vs. 0.073 [0.056–0.097] µg/kg/min, p < 0.001). Consequently, median infusion rate of remifentanil during anesthesia was higher in moderate NMB group (0.076 [0.096–0.067] µg/kg/min vs. 0.067 [0.084–0.058] µg/kg/min, p = 0.016). The duration of post-anesthesia care unit stay was longer in the moderate NMB group (40 [30–40] min vs. 30 [30–40] min, p = 0.045). In conclusion, deep NMB reduced the remifentanil requirement compared with moderate NMB in SPI-guided anesthesia for laparoscopic herniorrhaphy.https://doi.org/10.1038/s41598-022-23876-5 |
| spellingShingle | In Kyong Yi Jin-Soo Kim Hoon Hur Do-Gyun Han Ji Eun Kim Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trial Scientific Reports |
| title | Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trial |
| title_full | Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trial |
| title_fullStr | Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trial |
| title_full_unstemmed | Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trial |
| title_short | Effects of deep neuromuscular block on surgical pleth index-guided remifentanil administration in laparoscopic herniorrhaphy: a prospective randomized trial |
| title_sort | effects of deep neuromuscular block on surgical pleth index guided remifentanil administration in laparoscopic herniorrhaphy a prospective randomized trial |
| url | https://doi.org/10.1038/s41598-022-23876-5 |
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