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Comparison effects of two muscle relaxant strategies on postoperative pulmonary complications in transapical transcatheter aortic valve implantation: a propensity score-matched analysis.
J Cardiothorac Surg. 2023 Feb 01; 18(1):50.JC

Abstract

BACKGROUND

Prior studies have reported conflicting results on the effect of sugammadex on postoperative pulmonary complications (PPCs) and research on this topic in transapical-transcatheter aortic valve implantation (TA-TAVI) was sparse. The current study aimed to investigate whether there were differences in the incidence of PPCs between two muscle relaxant strategies (rocuronium/sugammadex vs. cisatracurium/neostigmine) in patients undergoing TA-TAVI.

METHODS

This retrospective observational study enrolled 245 adult patients underwent TA-TAVI between October 2018 and January 2021. The patients were grouped according to the type of muscle relaxant strategies (115 with rocuronium/sugammadex in the R/S group and 130 with cisatracurium/neostigmine in the C/N group, respectively). Pre- and intraoperative variables were managed by propensity score match (PSM) at a 1:2 ratio. PPCs (i.e., respiratory infection, pleural effusion, pneumothorax, atelectasis, respiratory failure, bronchospasm and aspiration pneumonitis) were evaluated from the radiological and laboratory findings.

RESULTS

After PSM, 91 patients in the R/S group were selected and matched to 112 patients in the C/N group. Patients in the R/S group showed lower PPCs rate (45.1% vs. 61.6%, p = 0.019) compared to the C/N group. In addition, the R/S group showed significant shorter extubation time (7.2 ± 6.2 vs. 10.3 ± 8.2 min, p = 0.003) and length of hospital stay (6.9 ± 3.3 vs. 8.0 ± 4.0 days, p = 0.034).

CONCLUSION

The rocuronium/sugammadex muscle relaxant strategy decreases the incidence of PPCs in patients undergoing TA-TAVI when compared to cisatracurium/neostigmine strategy. Trial registration ChiCTR, ChiCTR2100044269. Registered March 14, 2021-Prospectively registered, http://www.Chictr.org.cn .

Links

Authors+Show Affiliations

Department of Anesthesiology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China.

Department of Anesthesiology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China.

Department of Anesthesiology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China.

Department of Anesthesiology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China.

Department of Anesthesiology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China.

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.

Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China.

Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA.

Department of Anesthesiology, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China. d_xiaoqian@163.com.

Department of Anesthesiology, Day Surgery Center, West China Hospital, Sichuan University, No.37 Guoxue Alley, Chengdu, 610041, China. liangpeng_world@foxmail.com.

MeSH

AdultHumansNeostigminePropensity ScoreRocuroniumSugammadexTranscatheter Aortic Valve ReplacementPostoperative ComplicationsMuscles

Pub Type(s)

Observational Study

Journal Article

Language

eng

PubMed ID

36721168

Citation

Yu, Hong, et al. "Comparison Effects of Two Muscle Relaxant Strategies On Postoperative Pulmonary Complications in Transapical Transcatheter Aortic Valve Implantation: a Propensity Score-matched Analysis." Journal of Cardiothoracic Surgery, vol. 18, no. 1, 2023, p. 50.

Yu H, Zuo Y, Xu Z, et al. Comparison effects of two muscle relaxant strategies on postoperative pulmonary complications in transapical transcatheter aortic valve implantation: a propensity score-matched analysis. J Cardiothorac Surg. 2023;18(1):50.

Yu, H., Zuo, Y., Xu, Z., Zhao, D., Yue, J., Liu, L., Guo, Y., Huang, J., Deng, X., & Liang, P. (2023). Comparison effects of two muscle relaxant strategies on postoperative pulmonary complications in transapical transcatheter aortic valve implantation: a propensity score-matched analysis. Journal of Cardiothoracic Surgery, 18(1), 50. https://doi.org/10.1186/s13019-023-02166-9

Yu H, et al. Comparison Effects of Two Muscle Relaxant Strategies On Postoperative Pulmonary Complications in Transapical Transcatheter Aortic Valve Implantation: a Propensity Score-matched Analysis. J Cardiothorac Surg. 2023 Feb 1;18(1):50. PubMed PMID: 36721168.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Comparison effects of two muscle relaxant strategies on postoperative pulmonary complications in transapical transcatheter aortic valve implantation: a propensity score-matched analysis. AU - Yu,Hong, AU - Zuo,Yiding, AU - Xu,Zhao, AU - Zhao,Dailiang, AU - Yue,Jianming, AU - Liu,Lulu, AU - Guo,Yingqiang, AU - Huang,Jiapeng, AU - Deng,Xiaoqian, AU - Liang,Peng, Y1 - 2023/02/01/ PY - 2022/10/17/received PY - 2023/01/24/accepted PY - 2023/2/1/entrez PY - 2023/2/2/pubmed PY - 2023/2/3/medline KW - Cisatracurium/neostigmine KW - Neuromuscular blockade KW - Postoperative pulmonary complications KW - Rocuronium/sugammadex KW - Transcatheter aortic valve implantation SP - 50 EP - 50 JF - Journal of cardiothoracic surgery JO - J Cardiothorac Surg VL - 18 IS - 1 N2 - BACKGROUND: Prior studies have reported conflicting results on the effect of sugammadex on postoperative pulmonary complications (PPCs) and research on this topic in transapical-transcatheter aortic valve implantation (TA-TAVI) was sparse. The current study aimed to investigate whether there were differences in the incidence of PPCs between two muscle relaxant strategies (rocuronium/sugammadex vs. cisatracurium/neostigmine) in patients undergoing TA-TAVI. METHODS: This retrospective observational study enrolled 245 adult patients underwent TA-TAVI between October 2018 and January 2021. The patients were grouped according to the type of muscle relaxant strategies (115 with rocuronium/sugammadex in the R/S group and 130 with cisatracurium/neostigmine in the C/N group, respectively). Pre- and intraoperative variables were managed by propensity score match (PSM) at a 1:2 ratio. PPCs (i.e., respiratory infection, pleural effusion, pneumothorax, atelectasis, respiratory failure, bronchospasm and aspiration pneumonitis) were evaluated from the radiological and laboratory findings. RESULTS: After PSM, 91 patients in the R/S group were selected and matched to 112 patients in the C/N group. Patients in the R/S group showed lower PPCs rate (45.1% vs. 61.6%, p = 0.019) compared to the C/N group. In addition, the R/S group showed significant shorter extubation time (7.2 ± 6.2 vs. 10.3 ± 8.2 min, p = 0.003) and length of hospital stay (6.9 ± 3.3 vs. 8.0 ± 4.0 days, p = 0.034). CONCLUSION: The rocuronium/sugammadex muscle relaxant strategy decreases the incidence of PPCs in patients undergoing TA-TAVI when compared to cisatracurium/neostigmine strategy. Trial registration ChiCTR, ChiCTR2100044269. Registered March 14, 2021-Prospectively registered, http://www.Chictr.org.cn . SN - 1749-8090 UR - https://www.unboundmedicine.com/medline/citation/36721168/Comparison_effects_of_two_muscle_relaxant_strategies_on_postoperative_pulmonary_complications_in_transapical_transcatheter_aortic_valve_implantation:_a_propensity_score_matched_analysis_ DB - PRIME DP - Unbound Medicine ER -