Publication: Evaluation of surgical condition during laparoscopic gynaecological surgery in patient with moderate vs deep neuromuscular block in low pressure pneumoperitoneum
| dc.contributor.author | Esa, Umairah | |
| dc.date.accessioned | 2026-08-08T23:43:23Z | |
| dc.date.available | 2026-08-08T23:43:23Z | |
| dc.date.issued | 2022 | |
| dc.description.abstract | Introduction The significant effect of deep neuromuscular block in laparoscopic surgery is still controversial and under investigation especially in lower pressure laparoscopic surgery. In this study, we investigate the effect of deep neuromuscular block on intraabdominal pressure, surgical space quality, post operative abdominal pain and post operative shoulder tip pain in laparoscopic gynaecological surgery. Material and method This is a randomized, double blinded control trial which randomized the patient to either the moderate NMB (train-of-four count (TOF) of 1 or 2) or deep NMB (post tetanic count(PTC) of 1 or 2). In both groups, rocuronium was used. Intermittent bolus of rocuronium was use in moderate NMB while intravenous infusion was used to sustain neuromuscular blockade in deep NMB. Each group was then reversed with sugammadex. At the beginning of surgery, the intra-abdominal pressure was set at 8 mmHg. Surgeon was allowed to increase the intraabdominal pressure if the surgical condition was unfavourable. Surgical condition was rated on a 4- point scale (1: excellent, 2: good but not optimum, 3: poor but acceptable, 4: unacceptable) at the end of surgery. Post operative abdominal pain and shoulder tip pain was assessed using numerical rating scale for pain. Score 0 define as no pain to 10 as severe pain at recovery area as time 0, 30 minutes and 24 hours post operative. Results A total of 70 patient completed the study. There was no difference in rate of increasing intraabdominal pressure between two groups (p-value: 0.172), but deep NMB required less pneumoperitoneum to complete the surgery with mean highest intraabdominal pressure of 10.31mmHg (1.39) whereas 11.54mmHg (1.69) in the moderate NMB. Mean surgical space condition score was significantly better in deep NMB group at 2.4(0.7) compared to moderate NMB at 3.2(0.66), (p<0.005). There was significantly lower post operative abdominal pain score in deep NMB but there is no significant difference in shoulder tip pain score between two groups. Conclusion Deep NMB enable the usage of lower intraabdominal pressure in laparoscopic surgery without interfering with surgical space condition and reduce the post operative abdominal pain score in 24 hours compare to moderate NMB | |
| dc.identifier.uri | https://erepo.usm.my/handle/123456789/24786 | |
| dc.language.iso | en | |
| dc.subject | - | |
| dc.title | Evaluation of surgical condition during laparoscopic gynaecological surgery in patient with moderate vs deep neuromuscular block in low pressure pneumoperitoneum | |
| dc.type | Resource Types::text::thesis::master thesis | |
| dspace.entity.type | Publication | |
| oairecerif.author.affiliation | Universiti Sains Malaysia |