Abstract：
OBJECTIVE: Post-operative urinary retention (POUR) is a known complication of hernia surgery. Minimally invasive inguinal hernia repair (IHR) is typically done under general anesthesia with neuromuscular blockade (NMB), which is commonly reversed with an anticholinesterase inhibitor paired with an anticholinergic agent. Sugammadex is a unique NMB reversal agent that does not have to be paired with an anticholinergic. We sought to explore the role of sugammadex in reducing the rate of POUR following these procedures.
METHODS: Data were collected retrospectively at a single institution between February 2016 and October 2019. We identified and studied patients who underwent minimally invasive IHR and received either sugammadex or neostigmine/glycopyrrolate for NMB reversal. The primary endpoint was POUR requiring bladder catheterization. Secondary endpoints included post-operative and 30-day readmissions.
RESULTS: 274 patients were included in this study (143 received neostigmine and glycopyrrolate, 131 sugammadex). The sugammadex patients were on average 5 years older than the neostigmine/ glycopyrrolate patients (63.2 vs 58.2, p = 0.003), and received less median intravenous fluids (IVF) (900 ml vs 1000 ml; p = 0.015). There was a significant difference in the rate of POUR between the sugammadex and neostigmine/glycopyrrolate patients (0.0% vs 8.4%, p ≤ 0.001). The difference remained significant after controlling for age and IVF. The odds of POUR for those who received neostigmine/glycopyrrolate were 25 × higher than the odds of those who received sugammadex.
CONCLUSIONS: The results of this study reflect the protective role of sugammadex against POUR in minimally invasive IHR cases.
METHODS: Data were collected retrospectively at a single institution between February 2016 and October 2019. We identified and studied patients who underwent minimally invasive IHR and received either sugammadex or neostigmine/glycopyrrolate for NMB reversal. The primary endpoint was POUR requiring bladder catheterization. Secondary endpoints included post-operative and 30-day readmissions.
RESULTS: 274 patients were included in this study (143 received neostigmine and glycopyrrolate, 131 sugammadex). The sugammadex patients were on average 5 years older than the neostigmine/ glycopyrrolate patients (63.2 vs 58.2, p = 0.003), and received less median intravenous fluids (IVF) (900 ml vs 1000 ml; p = 0.015). There was a significant difference in the rate of POUR between the sugammadex and neostigmine/glycopyrrolate patients (0.0% vs 8.4%, p ≤ 0.001). The difference remained significant after controlling for age and IVF. The odds of POUR for those who received neostigmine/glycopyrrolate were 25 × higher than the odds of those who received sugammadex.
CONCLUSIONS: The results of this study reflect the protective role of sugammadex against POUR in minimally invasive IHR cases.
摘要：
目的：术后尿潴留（POUR）是已知的疝气手术并发症。微创腹股沟疝修补术（IHR）通常在神经肌肉阻滞（NMB）的全身麻醉下完成。通常用抗胆碱酯酶抑制剂与抗胆碱能药配对逆转。Sugammadex是一种独特的NMB逆转剂，不必与抗胆碱能药物配对。我们试图探索sugammadex在降低POUR率方面的作用。
方法：数据是在2016年2月至2019年10月期间在单个机构进行回顾性收集的。我们确定并研究了接受微创IHR并接受Sugamadex或新斯的明/格隆溴铵逆转NMB的患者。主要终点是POUR需要膀胱导管插入术。次要终点包括术后和30天再入院。
结果：本研究包括274例患者（143例接受了新斯的明和格隆溴铵，131sugammadex）。Sugammadex患者平均比新斯的明/格隆铵患者大5岁（63.2vs58.2，p=0.003），接受的中位静脉输液（IVF）较少（900mlvs1000ml；p=0.015）。Sugamadex和新斯的明/格隆溴铵患者的POUR发生率存在显着差异（0.0％vs8.4％，p≤0.001)。在控制年龄和IVF后，差异仍然显着。接受新斯的明/格隆溴铵的人的POUR几率比接受sugammadex的人高25倍。
结论：本研究结果反映了Sugammadex在微创IHR病例中对POUR的保护作用。
方法：数据是在2016年2月至2019年10月期间在单个机构进行回顾性收集的。我们确定并研究了接受微创IHR并接受Sugamadex或新斯的明/格隆溴铵逆转NMB的患者。主要终点是POUR需要膀胱导管插入术。次要终点包括术后和30天再入院。
结果：本研究包括274例患者（143例接受了新斯的明和格隆溴铵，131sugammadex）。Sugammadex患者平均比新斯的明/格隆铵患者大5岁（63.2vs58.2，p=0.003），接受的中位静脉输液（IVF）较少（900mlvs1000ml；p=0.015）。Sugamadex和新斯的明/格隆溴铵患者的POUR发生率存在显着差异（0.0％vs8.4％，p≤0.001)。在控制年龄和IVF后，差异仍然显着。接受新斯的明/格隆溴铵的人的POUR几率比接受sugammadex的人高25倍。
结论：本研究结果反映了Sugammadex在微创IHR病例中对POUR的保护作用。
