Impact of neuromuscular block on MINS incidence in the early postoperative stage of elderly patients undergoing laparoscopic colorectal cancer resection: A Randomized Controlled Study

Abstract

Abstract Background Myocardial injury after non-cardiac surgery (MINS) is a common and serious complication in elderly patients. This study investigates the impact of neuromuscular block on the MINS incidence and other cardiovascular complications in the early postoperative stage of elderly patients undergoing laparoscopic colorectal cancer resection. Methods 70 elderly patients who underwent laparoscopic colorectal cancer resection were separated into the deep neuromuscular block group and moderate neuromuscular block group for 35 cases in each group (n = 1:1). The deep neuromuscular block group maintained train of four (TOF) = 0, post-tetanic count (PTC) 1–2, and the moderate neuromuscular block group maintained TOF = 1–2 during the operation. Sugammadex sodium was used at 2 mg/kg or 4 mg/kg for muscle relaxation antagonism at the end of surgery. Postoperative follow-up was performed to compare MINS incidence and other cardiovascular complications during the first 7 days after surgery. Results MINS were not observed in both groups. The highest incidence of postoperative cardiovascular complications was lower limbs deep vein thrombosis (11.4%). The numeric rating scale score in the deep neuromuscular block group was lower than the moderate neuromuscular block group 72 h after surgery (P = 0.018). The operation time in the deep neuromuscular block group was longer (P = 0.008), the dosage of propofol and remifentanil was less (P = 0.043; P < 0.001), and the length of hospital stay was shorter than the moderate neuromuscular block group (P = 0.028). Conclusions Maintaining different degrees of the neuromuscular block under TOF guidance did not change the MINS incidence within 7 days after surgery in elderly patients who underwent laparoscopic colorectal cancer resection. Trial registration The present study was registered in the Chinese Clinical Trial Registry (10/02/2021, ChiCTR2100043323).