title: Effect of pneumoperitoneum on the recovery from intense neuromuscular blockade by rocuronium in healthy patients undergoing laparoscopic surgery.
abstract: BACKGROUND
  This study investigated the effect of pneumoperitoneum on the recovery from intense neuromuscular blockade by rocuronium in healthy patients undergoing laparoscopic abdominal surgery.
  
  
  METHODS
  Thirty adult patients undergoing laparoscopic abdominal surgery were studied. Anesthesia was induced with 1.5 mg/kg of propofol, 12 ug/kg of alfentanil and 0.6 mg/kg of rocuronium and maintained with 2 vol% of sevoflurane and 0.05-0.2 µg/kg/min remifentanil. The neuromuscular relaxation was monitored by Train-of-Four (TOF) and post-tetanic count (PTC). Additional rocuronium of 0.2 mg/kg was administered for deep neuromuscular blockade at 30 min after pneumoperitoneum. Before (PPpre) and 30 min after pneumoperitoneum (PPpost), PTC was measured at 6 min intervals. The relationship between PTC and the time interval to reappearance of T1 response was observed.
  
  
  RESULTS
  The mean ± SD of the intervals between the detection of 4 counts of the PTC and the first response to TOF stimulation was 13.0 ± 1.1 min and 16.4 ± 6.3 min PPpre and PPpost, respectively (P = 0.20). There were significant negative relationships between PTC observed and the time interval to reappearance of T1 response (adjusted R(2) = 0.869, P < 0.001 for PPpre data, and adjusted R(2) = 0.561, P < 0.001 for PPpost data). Comparing the difference of regression equation between PPpre and PPpost data using a parallelism test, there was no statistically significant difference (P = 0.193).
  
  
  CONCLUSIONS
  This study showed that PP with intra-abdominal pressure at the level of 13-14 mmHg did not affect the recovery from intense neuromuscular blockade by rocuronium in healthy patients undergoing laparoscopic abdominal surgery.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Hong Soon
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Dong Chul
authors.initials: DC
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Mi Geum
authors.initials: MG
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Woon Rak
authors.initials: WR
authors.lastname: Son
authors.affiliation: Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Yong Beom
authors.initials: YB
authors.lastname: Kim
keywords: Neuromuscular blockade; Neuromuscular monitoring; Pneumoperitoneum; Rocuronium
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