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Use of rocuronium and sugammadex for video-assisted thoracoscopic surgery is associated with reduced duration of chest tube drainage: a propensity score-matched analysis.
Br J Anaesth. 2023 Jan; 130(1):e119-e127.BJ

Abstract

BACKGROUND

We investigated the influence of different neuromuscular blocking agents and reversal agents during anaesthesia on early removal of chest tube drainage after video-assisted thoracoscopic surgery (VATS).

METHODS

This retrospective single-centre study included patients who underwent VATS after tracheal intubation under general anaesthesia. Patients received either cisatracurium and neostigmine (n=547) or rocuronium and sugammadex (n=151). Quantitative neuromuscular monitoring was used and one chest tube (size 24 Fr) was inserted. To reduce potential bias, 140 patients from each group were matched by propensity score for sex, age, body mass index and indication for VATS. Primary outcome was duration of chest tube drainage after surgery.

RESULTS

Use of rocuronium and sugammadex was associated with a shorter duration of chest tube drainage (2 [1-2] vs 2 [1-3] days; P=0.049) and a 63% reduction in delayed chest tube removal (odds ratio 0.37; 95% confidence interval [CI]: 0.20-0.67; P=0.005). This group also had a lower incidence of postoperative atelectasis (P=0.047) and consolidation (P=0.008). Each 1 h increase in the duration of anaesthesia was associated with a 1.57-fold increase in the delayed removal of the chest tube (95% CI: 1.25-1.96; P=0.005).

CONCLUSIONS

During general anaesthesia for VATS, compared with cisatracurium and neostigmine, use of rocuronium and sugammadex was associated with a significant decrease in the incidence of postoperative delayed removal of the chest tube, atelectasis, and pulmonary consolidation.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Wu EB
Department of Anaesthesiology, Kaohsiung, Taiwan.
Huang SC
Department of Anaesthesiology, Kaohsiung, Taiwan.
Lu HI
Department of Thoracic Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Illias AM
Department of Anaesthesiology, Linko Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan. Electronic address: aminailliasma@gmail.com.
Wang PM
Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Huang CJ
Department of Anaesthesiology, Kaohsiung, Taiwan.
Shih TH
Department of Anaesthesiology, Kaohsiung, Taiwan.
Chin JC
Department of Anaesthesiology, Park One International Hospital, Kaohsiung, Taiwan.
Wu SC
Department of Anaesthesiology, Kaohsiung, Taiwan. Electronic address: shaochunwu@gmail.com.

MeSH

HumansSugammadexRocuroniumNeostigmineThoracic Surgery, Video-AssistedCholinesterase InhibitorsRetrospective StudiesChest TubesPropensity ScoreNeuromuscular Nondepolarizing AgentsNeuromuscular BlockadeAnesthesia, GeneralDrainagePulmonary Atelectasis

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36038393

Citation

Wu, En-Bo, et al. "Use of Rocuronium and Sugammadex for Video-assisted Thoracoscopic Surgery Is Associated With Reduced Duration of Chest Tube Drainage: a Propensity Score-matched Analysis." British Journal of Anaesthesia, vol. 130, no. 1, 2023, pp. e119-e127.
Wu EB, Huang SC, Lu HI, et al. Use of rocuronium and sugammadex for video-assisted thoracoscopic surgery is associated with reduced duration of chest tube drainage: a propensity score-matched analysis. Br J Anaesth. 2023;130(1):e119-e127.
Wu, E. B., Huang, S. C., Lu, H. I., Illias, A. M., Wang, P. M., Huang, C. J., Shih, T. H., Chin, J. C., & Wu, S. C. (2023). Use of rocuronium and sugammadex for video-assisted thoracoscopic surgery is associated with reduced duration of chest tube drainage: a propensity score-matched analysis. British Journal of Anaesthesia, 130(1), e119-e127. https://doi.org/10.1016/j.bja.2022.07.046
Wu EB, et al. Use of Rocuronium and Sugammadex for Video-assisted Thoracoscopic Surgery Is Associated With Reduced Duration of Chest Tube Drainage: a Propensity Score-matched Analysis. Br J Anaesth. 2023;130(1):e119-e127. PubMed PMID: 36038393.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of rocuronium and sugammadex for video-assisted thoracoscopic surgery is associated with reduced duration of chest tube drainage: a propensity score-matched analysis. AU - Wu,En-Bo, AU - Huang,Shi-Cong, AU - Lu,Hung-I, AU - Illias,Amina M, AU - Wang,Pei-Ming, AU - Huang,Chia-Jung, AU - Shih,Tsung-Hsiao, AU - Chin,Jo-Chi, AU - Wu,Shao-Chun, Y1 - 2022/08/26/ PY - 2021/11/1/received PY - 2022/7/20/revised PY - 2022/7/21/accepted PY - 2022/8/30/pubmed PY - 2023/1/4/medline PY - 2022/8/29/entrez KW - chest tube KW - cisatracurium KW - enhanced recovery after surgery KW - neostigmine KW - rocuronium KW - sugammadex KW - video-assisted thoracoscopic surgery SP - e119 EP - e127 JF - British journal of anaesthesia JO - Br J Anaesth VL - 130 IS - 1 N2 - BACKGROUND: We investigated the influence of different neuromuscular blocking agents and reversal agents during anaesthesia on early removal of chest tube drainage after video-assisted thoracoscopic surgery (VATS). METHODS: This retrospective single-centre study included patients who underwent VATS after tracheal intubation under general anaesthesia. Patients received either cisatracurium and neostigmine (n=547) or rocuronium and sugammadex (n=151). Quantitative neuromuscular monitoring was used and one chest tube (size 24 Fr) was inserted. To reduce potential bias, 140 patients from each group were matched by propensity score for sex, age, body mass index and indication for VATS. Primary outcome was duration of chest tube drainage after surgery. RESULTS: Use of rocuronium and sugammadex was associated with a shorter duration of chest tube drainage (2 [1-2] vs 2 [1-3] days; P=0.049) and a 63% reduction in delayed chest tube removal (odds ratio 0.37; 95% confidence interval [CI]: 0.20-0.67; P=0.005). This group also had a lower incidence of postoperative atelectasis (P=0.047) and consolidation (P=0.008). Each 1 h increase in the duration of anaesthesia was associated with a 1.57-fold increase in the delayed removal of the chest tube (95% CI: 1.25-1.96; P=0.005). CONCLUSIONS: During general anaesthesia for VATS, compared with cisatracurium and neostigmine, use of rocuronium and sugammadex was associated with a significant decrease in the incidence of postoperative delayed removal of the chest tube, atelectasis, and pulmonary consolidation. SN - 1471-6771 UR - https://www.unboundmedicine.com/medline/citation/36038393/Use_of_rocuronium_and_sugammadex_for_video_assisted_thoracoscopic_surgery_is_associated_with_reduced_duration_of_chest_tube_drainage:_a_propensity_score_matched_analysis_ DB - PRIME DP - Unbound Medicine ER -