Effects Of Sugammadex On Early Postoperative Recovery In Patients Undergoing Thoracoscopic-laparoscopic Radical Esophagectomy

ObjectiveTo investigate the effects of sugammadex on early postoperative recovery in patients with general anesthesia undergoing thoracoscopic-laparoscopic radical esophagectomy and provide a reference for optimizing perioperative neuromuscular management and improving the quality of patients’early postoperative recovery.MethodNinety-sixpatientswithgeneralanesthesiaundergoing thoracoscopic-laparoscopic radical esophagectomy of both sexes were selected,aged18-65 years,BMI 18-25 kg/m²,ASA physical statusⅠorⅡ.Patients were divided into two groups:control group（group C）and sugammadex group（group S）,with 48patients in each group using a random digital table:both groups were induced by general anesthesia with propofol,sufentanil,etomidate and rocuronium,and neuromuscular blockade was assessed with a train-of-four（TOF）stimulus.At the end of surgery,when T2 of TOF appeared,group C received intravenous neostigmine0.05 mg/kg combined with atropine 0.02 mg/kg,and group S received intravenous sugammadex 2 mg/kg.The time from the administration of neuromuscular blockade antagonists to the recovery of TOF ratio（TOFR）to 0.9（time to recovery from neuromuscular blockade）,and the time from the administration of neuromuscular blockade antagonists to the extubation（time to extubation）were recorded.The incidence of residual neuromuscular blockade was calculated at 5,15,and 30 min（T₁、T₂、T₃）after administration of neuromuscular blockade antagonists.Patients’40-item Quality of Recovery score（Qo R-40）were recorded at 24h and 48h（T₄、T₅）post-operatively.The time of first postoperative leaving bed,flatus and feces were recorded.The incidence of postoperative pulmonary complications,nausea and vomiting（PONV）and paralytic ileus were recorded.Results（1）There was no statistically significant difference between the two groups in terms of gender,age,BMI,ASA classification and smoking history（P>0.05）.（2）There was no statistically significant difference in operating time,anesthesia time,intraoperative rehydration,intraoperative bleeding and urine volume between the two groups（P>0.05）,and no statistically significant difference in the dosage of propofol,sufentanil,remifentanil and rocuronium between the two groups（P>0.05）.（3）Compared with group C,group S had shorter time to recovery from neuromuscular blockade and time to extubation,and the differences were statistically significant（P<0.05）.After the administration of neuromuscular blockade antagonists,the residual rate of neuromuscular blockade in group S was lower than that in group C at T₁and T₂,and the difference was statistically significant（P<0.05）.After administration of neuromuscular blockade antagonists,there was no statistically significant difference in the residual rate of neuromuscular blockade between the two groups at T₃（P>0.05）.（4）Compared with Group C,patients in Group S had higher scores in the comfort,mood and behaviour categories and total scores on the Qo R-40 scale at T₄（P<0.05）,and patients in Group S had higher scores in the comfort category on the Qo R-40 scale at T₅（P<0.05）,while the differences in scores in the other categories and total scores were not statistically significant（P>0.05）;compared with Group C,patients in Group S had shorter time to first leaving bed and first postoperative flatus after surgery（P<0.05）;there was no statistically significant difference in the time to first postoperative feces between the two groups（P>0.05）.（5）Compared with Group C,the overall incidence of postoperative pulmonary complications was lower in Group S patients（P<0.05）;the difference in the incidence of postoperative PONV between the two groups was not statistically significant（P>0.05）;the difference in the incidence of postoperative paralytic bowel obstruction between the two groups was not statistically significant（P>0.05）.ConclusionSugammadex can reverse the residual neuromuscular blockade induced by rocuronium within shorter time in patients undergoing thoracoscopic-laparoscopic radical esophagectomy,contribute to the recovery from neuromuscular blockade and reducing the residual rate of neuromuscular blockade;contribute to shortening the time to first leaving bed and time to first postoperative flatus;reduce the incidence of postoperative pulmonary complications,improve patients’postoperative recovery comfort and the quality of patients’early postoperative recovery.