Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1405
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
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.
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.
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.
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.
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.
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.
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.