Effect Of Sugammadex On The Postoprative Fast Track In Patients After Laparoscopic Minimally Invasive Gallbladder-Preserving Surgery

Objective:The study was designed to observe the effect of sugammadex on the postoprative fast track in patients after laparoscopic minimally invasive gallbladder-preserving surgeryMethods:Sixty ASA I-II patients aged 18-65 years undergoing elective laparoscopic minimally invasive gallbladder-preserving surgery were randomly assigned to two groups:Sugammadex（S）group and Neostigmine（N）group,30 cases in each group.The induction and maintenenance drugs were consistent in two groups.General anesthesia was induced with intravenous midazolam 0.03 mg/kg,propofol 1.5 mg/kg,sufentanil 0.4μg/kg and rocuronium 0.9 mg/kg.Anesthesia was maintained with propofol 6mg/（kg·h）and remifentanil 0.012 mg/（kg·h）.Neuromuscular blockade was monitored by the train-of-four（TOF）.The drugs were discontinued at the end of the operation,and the antagonists were given when TOF was restored to T2.Sugammadex4mg/kg was administered in group S,and neostigmine 0.05mg/kg and atropine0.01mg/kg was administered in group N.The characteristics of patients,intraoperative MAP,intraoperative TOFr（train of four stimulation ratio）,postoperative recovery time of TOFr by90%,extubation time,the time of postoperative ambulation,first intestine venting and discharge,incidence of adverse reactions,MAP,HR and Sp O₂before and after antagonism were recorded.Results:（1）Compared with group N,the recovery time of 90%TOFr and extubation time in group S were significantly shorter,and the difference was statistically significant（P<0.001）.（2）There was no significant difference in HR and MAP between the two groups immediately after medication（P>0.05）.There was no significant difference in MAP between the two groups 5 min after administration（P>0.05）.However,there was no significant change in HR in group S,but the HR in group N slowed down.There was a difference in HR between the two groups,with statistical significance（P<0.05）.（3）Group N:3 cases of bradycardia,1cases of nausea and vomiting;there were no related adverse reactions such as allergy,nausea and vomiting and abnormal sensation in group S.（4）Group S:the time of postoperative ambulation and first intestine venting was shorter,with statistical significance（P<0.05）.Conclusion:Sugammadex 4mg/kg can antagonize residual muscle relaxant by rocuronium after laparoscopic minimally invasive gallbladder-preserving surgery:sugammadex can shorten the recovery time of TOFr by 90%and extubation time,reduce postoperative ambulation time and first intestine venting time and reduce the bradycardia and incidence of adverse reactions during recovery period which is beneficial to the rapid recovery of patients.