scholarly journals Effect of Neuromuscular Blockade on Intraoperative Respiratory Mechanics and Surgical Space Conditions during Robot-Assisted Radical Prostatectomy: A Prospective Randomized Controlled Trial

2021 ◽  
Vol 10 (21) ◽  
pp. 5090
Author(s):  
Chang-Hoon Koo ◽  
Insun Park ◽  
Sungmin Ahn ◽  
Sangchul Lee ◽  
Jung-Hee Ryu
Keyword(s):  
Radical Prostatectomy ◽  
Neuromuscular Blockade ◽  
Respiratory Mechanics ◽  
Controlled Trial ◽  
Peak Inspiratory Pressure ◽  
Robot Assisted ◽  
Co2 Insufflation ◽  
Number Of Patients ◽  
Surgical Conditions ◽  
Surgical Condition

The aim of this study was to investigate whether deep neuromuscular blockade (NMB) may affect intraoperative respiratory mechanics, surgical condition, and recovery profiles in patients undergoing robot-assisted radical prostatectomy (RARP). Patients were randomly assigned to the moderate or deep NMB groups. Pneumoperitoneum was maintained with carbon dioxide (CO2) insufflation at 15 mmHg during surgery. The primary outcome was peak inspiratory pressure (PIP) after CO2 insufflation. Mean airway pressure (Pmean) and dynamic lung compliance (Cdyn) were also recorded. The surgeon rated the surgical condition and surgical difficulty on a five-point scale (1 = extremely poor; 2 = poor; 3 = acceptable; 4 = good; 5 = optimal). Recovery profiles, such as pulmonary complications, pain scores, and recovery time, were recorded. We included 58 patients in this study. No significant differences were observed regarding intraoperative respiratory mechanics including PIP, Pmean and Cdyn, between the two groups. The number of patients with optimal surgical conditions was significantly higher in the deep than in the moderate NMB group (29 vs. 20, p = 0.014). We found no differences in recovery profiles. In conclusion, deep NMB had no significant effect on the intraoperative respiratory mechanics but resulted in optimal endoscopic surgical conditions during RARP compared with moderate NMB.

scholarly journals Supported progressive resistance exercise training to counter the adverse side effects of robot-assisted radical prostatectomy: a randomised controlled trial

2021 ◽  
Author(s):  
Ruth E. Ashton ◽  
Jonathan J. Aning ◽  
Garry A. Tew ◽  
Wendy A Robson ◽  
John M Saxton
Keyword(s):  
Randomised Controlled Trial ◽  
Radical Prostatectomy ◽  
Muscular Strength ◽  
Controlled Trial ◽  
Control Group ◽  
Robot Assisted ◽  
Resistance Exercise Training ◽  
Home Based ◽  
Aerobic Exercise Capacity ◽  
Randomised Controlled

Abstract Purpose To investigate the effects of a supported home-based progressive resistance exercise training (RET) programme on indices of cardiovascular health, muscular strength and health-related quality of life (HR-QoL) in prostate cancer (PCa) patients after treatment with robot-assisted radical prostatectomy (RARP). Methods This study was a single-site, two-arm randomised controlled trial, with 40 participants randomised to either the intervention or control group over a 10-month period. In addition to receiving usual care, the intervention group completed three weekly RET sessions using resistance bands for 6 months. Participants performed 3 sets of 12–15 repetitions for each exercise, targeting each major muscle group. The control group received usual care only. Brachial artery flow-mediated dilatation (FMD) was the primary outcome and assessed at baseline, 3 and 6 months. Secondary outcomes included body weight, body fat, aerobic fitness, strength and blood-borne biomarkers associated with cardiometabolic risk. Results There was no significant difference between the groups in FMD at 3 or 6 months. However, there were improvements in aerobic exercise capacity (P < 0.01) and upper- (P < 0.01) and lower-limb (P = 0.01) strength in favour of the RET group at 6 months, accompanied by greater weight loss (P = 0.04) and a reduction in body fat (P = 0.02). Improvements in HRQoL were evident in the RET group at 3 and 6 months via the PCa-specific component of the FACT-P questionnaire (both P < 0.01). Five adverse events and one serious adverse event were reported throughout the trial duration. Conclusion This study demonstrates that home-based RET is an effective and safe mode of exercise that elicits beneficial effects on aerobic exercise capacity, muscular strength and HR-QoL in men who have undergone RARP. Trial registration ISRCTN10490647.

scholarly journals Clinical profile and outcome of pediatric surgical patients in a rural tertiary centre

2021 ◽  
Author(s):  
Sunil Pathak ◽  
R. V. Mhapsekar ◽  
Neeraj Gupta ◽  
Karthik Surabhi ◽  
Shruchi Bhargava ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Clinical Profile ◽  
Surgical Patients ◽  
Curative Therapy ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Important Means ◽  
Surgical Conditions ◽  
Time Of Admission ◽  
Surgical Condition

Background: Pediatric surgery is a sub-speciality involving the surgery of foetuses, infants, children and adolescents. Congenital malformations, trauma and childhood cancers are their three major concerns requiring the focus of their attention. Rural pediatric population in India still remains devoid of such facilities. Little is factually known about the burden of surgical disease globally. Surgical treatment is an essential component of basic medical care and an important means of providing preventive and curative therapy. Pediatrician has a significant role in caring for surgical patients. There is a need to know the spectrum of diseases that warrant admission into the pediatric surgical units. Current study was conducted to find out the clinical profile and immediate outcome of the various pediatric surgical conditions. Methods: This prospective observational study was conducted at Vadodara. All the patients 0-18 years, with surgical condition were enrolled in the study. Patients were followed from the time of admission to discharge.  All the clinical data from admission to discharge were recorded and analyzed.Results: Total 127 (3%) patients were enrolled in the study. Males were 93 (73.2%). One to 5 years 45 (35.4%) was the largest age group folowed by infants 23 (18.1%). Largest number of patients were from Gastro Intestinal Condition 52 (40.9%) and congenital causes forms 83 (65.35%) of admissions. Commonest congenital anomaly was inguinal hernia 23 (27.7%). Complications were recorded in 46 (36.22%) patients. The average duration of stay was 7.7 days. The 124 patients were discharged successfully.Conclusions: Surgical conditions are important part of pediatric and neonatal care. Management of congenital surgical condition is important to decrease infant and under five mortality and other comorbidities as well.

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