Zhang YW, Li Y, Huang WB, Wang J, Qian XE, Yang Y, Huang CS. Utilization of deep neuromuscular blockade combined with reduced abdominal pressure in laparoscopic radical gastrectomy for gastric cancer: An academic perspective. World J Gastrointest Surg 2023; 15(7): 1405-1415 [PMID: 37555115 DOI: 10.4240/wjgs.v15.i7.1405]
Corresponding Author of This Article
Chang-Shun Huang, MBChB, Chief Doctor, Department of Anesthesiology, Ningbo First Hospital, No. 59 Liuting Street, Haishu District, Ningbo 315016, Zhejiang Province, China. nbhcs1967@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2023; 15(7): 1405-1415 Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1405
Utilization of deep neuromuscular blockade combined with reduced abdominal pressure in laparoscopic radical gastrectomy for gastric cancer: An academic perspective
Yi-Wei Zhang, Yong Li, Wan-Bo Huang, Jue Wang, Xing-Er Qian, Yu Yang, Chang-Shun Huang, Department of Anesthesiology, Ningbo First Hospital, Ningbo 315016, Zhejiang Province, China
Author contributions: Zhang YW and Li Y designed the study, contributed equally to this study, are considered as co-first authors; Zhang YW, Li Y, Huang WB, Wang J, and Qian XE conducted the research; Yang Y contributed to the analytical tools; Zhang YW, Li Y and Huang CS analyzed the data and wrote the manuscript; and all authors read and approved the final manuscript.
Supported byZhejiang Health Science and Technology Plan 2022, No. 2022KY320.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the First Hospital of Ningbo (Ethical approval number: 2019R006).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no potential conflicts of interest.
Data sharing statement: Raw data and statistics are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chang-Shun Huang, MBChB, Chief Doctor, Department of Anesthesiology, Ningbo First Hospital, No. 59 Liuting Street, Haishu District, Ningbo 315016, Zhejiang Province, China. nbhcs1967@163.com
Received: March 14, 2023 Peer-review started: March 14, 2023 First decision: April 7, 2023 Revised: April 20, 2023 Accepted: June 2, 2023 Article in press: June 2, 2023 Published online: July 27, 2023 Processing time: 129 Days and 5.1 Hours
ARTICLE HIGHLIGHTS
Research background
Gastric cancer (GC) is a major health concern with increasing incidence, particularly among middle-aged and elderly individuals. Laparoscopic radical gastrectomy (LRG) is a primary treatment method for GC, but concerns exist regarding the impact of excessive pneumoperitoneum pressure on patients, especially the elderly.
Research motivation
Although deep neuromuscular blockade (NMB) has been shown to improve surgical conditions in various laparoscopic procedures, there is limited research on the effectiveness of deep NMB combined with reduced pneumoperitoneum pressure in LRG for elderly GC patients.
Research objectives
This study aimed to investigate the application effect of deep NMB combined with reduced pneumoperitoneum pressure in LRG for elderly GC patients and its influence on inflammation.
Research methods
A retrospective analysis of 103 elderly GC patients was conducted, comparing those treated with deep NMB and conventional pneumoperitoneum pressure (control group, n = 45) vs those treated with deep NMB and reduced pneumoperitoneum pressure (observation group, n = 58) in various outcome measures.
Research results
The observation group experienced lower postoperative pain, reduced inflammatory markers, and lower driving pressure at specific time points compared to the control group. No significant difference was observed in adverse event incidence, but the observation group had shorter hospitalization times and lower postoperative expenses.
Research conclusions
Deep NMB combined with reduced pneumoperitoneum pressure can decrease postoperative pain and inflammation without compromising surgical vision or increasing adverse respiratory events, ultimately leading to shorter hospitalization times and reduced treatment costs.
Research perspectives
This study provides valuable insights for clinicians when selecting therapeutic regimens for elderly GC patients undergoing LRG, highlighting the potential benefits of deep NMB combined with reduced pneumoperitoneum pressure.
