Deep neuromuscular blockade leads to a larger intraabdominal volume during laparoscopy

Astrid Listov Lindekaer, Henrik Halvor Springborg, Olav Istre

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Shoulder pain is a commonly reported symptom following laparoscopic procedures such as myomectomy or hysterectomy, and recent studies have shown that lowering the insufflation pressure during surgery may reduce the risk of post-operative pain. In this pilot study, a method is presented for measuring the intra-abdominal space available to the surgeon during laproscopy, in order to examine whether the relaxation produced by deep neuromuscular blockade can increase the working surgical space sufficiently to permit a reduction in the CO2 insufflation pressure. Using the laproscopic grasper, the distance from the promontory to the skin is measured at two different insufflation pressures: 8 mm Hg and 12 mm Hg. After the initial measurements, a neuromuscular blocking agent (rocuronium) is administered to the patient and the intra-abdominal volume is measured again. Pilot data collected from 15 patients shows that the intra-abdominal space at 8 mm Hg with blockade is comparable to the intra-abdominal space measured at 12 mm Hg without blockade. The impact of neuromuscular blockade was not correlated with patient height, weight, BMI, and age. Thus, using neuromuscular blockade to maintain a steady volume while reducing insufflation pressure may produce improved patient outcomes.

Original languageEnglish
JournalJournal of Visualized Experiments
Issue number76
Number of pages5
ISSN1940-087X
DOIs
Publication statusPublished - 25. Jun 2013

Bibliographical note

E-pub

Keywords

  • Abdominal Cavity
  • Female
  • Humans
  • Hysterectomy
  • Laparoscopy
  • Neuromuscular Blockade
  • Pain, Postoperative
  • Pilot Projects
  • Uterine Myomectomy

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