【原】分析舒更葡糖钠与腹部手术患者住院时间的关系：一项回顾性研究

分析舒更葡糖钠与腹部手术患者住院时间的关系：一项回顾性研究

贵州医科大学    麻醉与心脏电生理课题组

翻译：张中伟  编辑：张中伟  审校：曹莹

背景：舒更葡糖钠是一种较新的药物，其用于快速可靠地逆转神经肌肉阻滞。这项研究评估了舒更葡糖钠是否可以减少腹部手术患者的术后住院时间。

研究方法：这项单中心回顾性队列研究纳入了2015年1月至2019年10月期间接受重大腹部手术的患者。患者被随机分成两组，分别使用舒更葡糖钠或自行恢复。主要观察指标是术后住院时间。次要观察指标是麻醉复苏室(PACU)的停留时间、手术结束直至患者可站立行走时间、首次排便时间和肺部并发症的发生率。在1：1倾向得分匹配后，使用单变量和多元线性回归分析评估两组结果的差异。

主要结果：在1614名患者中，517名患者接受了舒更葡糖钠治疗，645名患者自行恢复。在调整了潜在的混杂因素后，舒更葡糖钠的应用与术后住院时间之间存在非线性关系(β=0.29，95%可信区间{CI}：[−1.13，−0.54]，P=0.4912)。与自然恢复组相比，舒更葡糖钠组术后PACU停留时间缩短(β=−20.3095%CI：[−24.48，−17.11]，P<0.0001)，手术结束直至患者可站立行走时间缩短(β=−0.43 95%CI：[−0.62，−0.23]，P<0.0001)，首次排便时间缩短(β=−2.25 95%CI：[−0.45，−0.05]，P=0.0129)。舒更葡糖钠组肺炎发生率为18.6%[44/237]，明显低于自然恢复组的39.2%[93/237](P<0.05)。

结论：腹部手术后使用舒更葡糖钠逆转神经肌肉阻滞可提高患者的恢复情况，并与肺炎发生风险降低有关，但不影响术后住院时间。

原始文献来源：Jing Tan, Jianhua He, Lijun Wang，et al.Analysis of the association of sugammadex with the length of hospital stay in patients undergoing abdominal surgery: a retrospective study.[J]. BMC Anesthesiology (2023) 23:32

英文原文 

Analysis of the association of sugammadex

with the length of hospital stay in patients undergoing abdominal surgery: a retrospective

study

Abstract

Background Sugammadex is a newer medication used for rapid and reliable reversal of neuromuscular blockade. This study evaluated whether sugammadex could reduce the length of postoperative hospital stay in patients undergoing abdominal surgery.

Methods This single center retrospective cohort study included patients who underwent major abdominal surgery between January 2015 and October 2019. Patients were randomized according to reversal with sugammadex or spontaneous recovery. The primary outcome was length of postoperative hospital stay. The secondary outcomes were length of post-anesthetic care unit (PACU) stay, postoperative ambulation time, time-to-first-defecation, and incidence of pulmonary complications. After 1:1 propensity score matching, univariate and multiple linear regression analyses estimated the differences in outcomes.

Results Of the 1614 patients, 517 received sugammadex and 645 spontaneously recovered. After adjusting for potential confounders, non-linear relationship was detected between administration of sugammadex and the length of postoperative hospital stay (β = 0.29 95% confidence interval {CI}: [− 1.13, − 0.54], P = 0.4912). However, it was associated with shorter PACU stay (β = − 20.30 95% CI: [− 24.48, − 17.11], P < 0.0001), shorter time to postoperative ambulation movement (β = − 0.43 95% CI: [− 0.62, − 0.23], P < 0.0001), and reduced time-to-first-defecation (β = − 2.25

95% CI: [− 0.45, − 0.05], P = 0.0129), when compared to the spontaneously recovered group. The incidence of pneumonia in the sugammadex group was significantly lower than that in the spontaneously recovered group (18.6% [44/237] vs. 39.2% [93/237] P < 0.05).

Conclusion Neuromuscular blockade reversal with sugammadex after abdominal surgery demonstrated an excellent recovery profile and was associated with decreased risk of pneumonia, although it did not affect the length of postoperative hospital stay.