<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Purpose</h3><p>During pneumoperitoneum (PP) for robot-assisted prostatectomy, a deep neuromuscular block (NMB) is necessary. New relaxometry equipment permits maintenance of profound NMB in order to improve patient safety and surgical conditions.</p></sec><sec><h3>Methods</h3><p>Twenty adult patients undergoing robot-assisted prostatectomy were included. Under automated quantitative relaxometry with the TOFcuffTM device, rocuronium dosing was adapted with the aim to keep NMB at deep levels. The time fractions with intense block (PTC 0), adequately deep block (PTC 1 to 3) and a not sufficiently deep block (PTC > 3) were quantified.</p></sec><sec><h3>Results</h3><p>An optimally deep block (PTC 1–3) was achieved during 110 ± 38 min (50 ± 15%). Intense block was found during 60 ± 45 min (27 ± 18%) of total PP time. Values of PTC > 3 lasted 60 ± 45 min (23 ± 17%). Median PTC always remained between 1 and 3. Inadvertent movements during PP were never encountered, and operation conditions as reported by the surgeons were excellent.</p></sec><sec><h3>Conclusion</h3><p>Our technique of controlled profound NMB by repetitive bolus doses achieved its goal in 77% of PP time. Under automated quantitative relaxometry, an optimized rocuronium dosing strategy should be applied to maintain a high level of safety and adequate operation conditions without risking an unnecessary prolongation of NMB into the post-pneumoperitoneum period.</p></sec></abstract>

PurposeDuring pneumoperitoneum (PP) for robot-assisted prostatectomy, a deep neuromuscular block (NMB) is necessary. New relaxometry equipment permits maintenance of profound NMB in order to improve patient safety and surgical conditions.MethodsTwenty adult patients undergoing robot-assisted prostatectomy were included. Under automated quantitative relaxometry with the TOFcuffTM device, rocuronium dosing was adapted with the aim to keep NMB at deep levels. The time fractions with intense block (PTC 0), adequately deep block (PTC 1 to 3) and a not sufficiently deep block (PTC > 3) were quantified.ResultsAn optimally deep block (PTC 1–3) was achieved during 110 ± 38 min (50 ± 15%). Intense block was found during 60 ± 45 min (27 ± 18%) of total PP time. Values of PTC > 3 lasted 60 ± 45 min (23 ± 17%). Median PTC always remained between 1 and 3. Inadvertent movements during PP were never encountered, and operation conditions as reported by the surgeons were excellent.ConclusionOur technique of controlled profound NMB by repetitive bolus doses achieved its goal in 77% of PP time. Under automated quantitative relaxometry, an optimized rocuronium dosing strategy should be applied to maintain a high level of safety and adequate operation conditions without risking an unnecessary prolongation of NMB into the post-pneumoperitoneum period.

Automated Quantitative Relaxometry for Deep Neuromuscular Blockade in Robot-Assisted Prostatectomy

Institute of Anesthesiology, University Hospital Zurich and Senior Researcher, Institute of Physiology

Romanian Journal of Anaesthesia and Intensive Care

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

PurposeDuring pneumoperitoneum (PP) for robot-assisted prostatectomy, a deep neuromuscular block (NMB) is necessary. New relaxometry equipment permits...

Automated Quantitative Relaxometry for Deep Neuromuscular Blockade in Robot-Assisted Prostatectomy

Article Category: Research Article

Published Online: Aug 10, 2020

Page range: 29 - 34

DOI: https://doi.org/10.2478/rjaic-2020-0004

Keywords
Neuromuscular monitoring, robot-assisted prostatectomy, deep neuromuscular block, relaxometry, rocuronium

© 2020 Michèle Sunnen et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Automated Quantitative Relaxometry for Deep Neuromuscular Blockade in Robot-Assisted Prostatectomy

Article Category: Research Article

Published Online: Aug 10, 2020

Page range: 29 - 34

DOI: https://doi.org/10.2478/rjaic-2020-0004

KeywordsNeuromuscular monitoring, robot-assisted prostatectomy, deep neuromuscular block, relaxometry, rocuronium

© 2020 Michèle Sunnen et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
Neuromuscular monitoring, robot-assisted prostatectomy, deep neuromuscular block, relaxometry, rocuronium