Cargando…

Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial

Microwave ablation (MWA) is gaining popularity for the treatment of small primary hepatocellular carcinoma and metastatic lesions especially if patients are not candidates for surgical resection. Deep neuromuscular blockade (DMB) is perceived to improve surgical working conditions compared to modera...

Descripción completa

Detalles Bibliográficos
Autores principales: Loh, Pui San, Yeong, Chai Hong, Masohood, Naeema S., Sulaiman, Norshazriman, Zaki, Rafdzah Ahmad, Fabell, Kamil, Abdullah, Basri Johan Jeet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840903/
https://www.ncbi.nlm.nih.gov/pubmed/33504909
http://dx.doi.org/10.1038/s41598-021-81913-1
_version_ 1783643679921012736
author Loh, Pui San
Yeong, Chai Hong
Masohood, Naeema S.
Sulaiman, Norshazriman
Zaki, Rafdzah Ahmad
Fabell, Kamil
Abdullah, Basri Johan Jeet
author_facet Loh, Pui San
Yeong, Chai Hong
Masohood, Naeema S.
Sulaiman, Norshazriman
Zaki, Rafdzah Ahmad
Fabell, Kamil
Abdullah, Basri Johan Jeet
author_sort Loh, Pui San
collection PubMed
description Microwave ablation (MWA) is gaining popularity for the treatment of small primary hepatocellular carcinoma and metastatic lesions especially if patients are not candidates for surgical resection. Deep neuromuscular blockade (DMB) is perceived to improve surgical working conditions compared to moderate neuromuscular blockade (MMB) but no studies have examined the same benefits in MWA of liver tumours. This study aimed to compare the clinical outcomes of DMB and MMB in MWA of liver tumours in terms of liver excursion, performance scores by the interventional radiologists and patients, requirements of additional muscle relaxants and complications. 50 patients were recruited and 45 patients (22 in MMB group, 23 in DMB group) completed the study. The mean liver excursion for the MMB group (1.42 ± 1.83 mm) was significantly higher than the DMB group (0.26 ± 0.38 mm) (p = 0.001). The mean Leiden-Surgical Rating Scale (L-SRS) rated by the two interventional radiologists were 4.5 ± 0.59 and 3.6 ± 0.85 for the DMB and MMB groups, respectively (p = 0.01). There was also statistically significant difference on patient satisfaction scores (0–10: Extremely Dissatisfied–Extremely Satisfied) between DMB (8.74 ± 1.1) and MMB (7.86 ± 1.25) groups (p = 0.01). 5 patients from MMB group and none from DMB group required bolus relaxant during the MWA procedure. Adverse events were also noted to be more severe in the MMB group. In conclusion, DMB significantly reduced liver excursion and movement leading to improved accuracy, safety and success in ablating liver tumour.
format Online
Article
Text
id pubmed-7840903
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-78409032021-01-28 Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial Loh, Pui San Yeong, Chai Hong Masohood, Naeema S. Sulaiman, Norshazriman Zaki, Rafdzah Ahmad Fabell, Kamil Abdullah, Basri Johan Jeet Sci Rep Article Microwave ablation (MWA) is gaining popularity for the treatment of small primary hepatocellular carcinoma and metastatic lesions especially if patients are not candidates for surgical resection. Deep neuromuscular blockade (DMB) is perceived to improve surgical working conditions compared to moderate neuromuscular blockade (MMB) but no studies have examined the same benefits in MWA of liver tumours. This study aimed to compare the clinical outcomes of DMB and MMB in MWA of liver tumours in terms of liver excursion, performance scores by the interventional radiologists and patients, requirements of additional muscle relaxants and complications. 50 patients were recruited and 45 patients (22 in MMB group, 23 in DMB group) completed the study. The mean liver excursion for the MMB group (1.42 ± 1.83 mm) was significantly higher than the DMB group (0.26 ± 0.38 mm) (p = 0.001). The mean Leiden-Surgical Rating Scale (L-SRS) rated by the two interventional radiologists were 4.5 ± 0.59 and 3.6 ± 0.85 for the DMB and MMB groups, respectively (p = 0.01). There was also statistically significant difference on patient satisfaction scores (0–10: Extremely Dissatisfied–Extremely Satisfied) between DMB (8.74 ± 1.1) and MMB (7.86 ± 1.25) groups (p = 0.01). 5 patients from MMB group and none from DMB group required bolus relaxant during the MWA procedure. Adverse events were also noted to be more severe in the MMB group. In conclusion, DMB significantly reduced liver excursion and movement leading to improved accuracy, safety and success in ablating liver tumour. Nature Publishing Group UK 2021-01-27 /pmc/articles/PMC7840903/ /pubmed/33504909 http://dx.doi.org/10.1038/s41598-021-81913-1 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Loh, Pui San
Yeong, Chai Hong
Masohood, Naeema S.
Sulaiman, Norshazriman
Zaki, Rafdzah Ahmad
Fabell, Kamil
Abdullah, Basri Johan Jeet
Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
title Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
title_full Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
title_fullStr Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
title_full_unstemmed Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
title_short Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
title_sort comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840903/
https://www.ncbi.nlm.nih.gov/pubmed/33504909
http://dx.doi.org/10.1038/s41598-021-81913-1
work_keys_str_mv AT lohpuisan comparisonofdeepandmoderateneuromuscularblockadeinmicrowaveablationoflivertumoursarandomizedcontrolledclinicaltrial
AT yeongchaihong comparisonofdeepandmoderateneuromuscularblockadeinmicrowaveablationoflivertumoursarandomizedcontrolledclinicaltrial
AT masohoodnaeemas comparisonofdeepandmoderateneuromuscularblockadeinmicrowaveablationoflivertumoursarandomizedcontrolledclinicaltrial
AT sulaimannorshazriman comparisonofdeepandmoderateneuromuscularblockadeinmicrowaveablationoflivertumoursarandomizedcontrolledclinicaltrial
AT zakirafdzahahmad comparisonofdeepandmoderateneuromuscularblockadeinmicrowaveablationoflivertumoursarandomizedcontrolledclinicaltrial
AT fabellkamil comparisonofdeepandmoderateneuromuscularblockadeinmicrowaveablationoflivertumoursarandomizedcontrolledclinicaltrial
AT abdullahbasrijohanjeet comparisonofdeepandmoderateneuromuscularblockadeinmicrowaveablationoflivertumoursarandomizedcontrolledclinicaltrial