Deep neuromuscular block attenuates intra-abdominal pressure and inflammation and improves post-operative cognition in prostate cancer patients following robotic-assisted radical prostatectomy

Abstract

Background: Whether neuromuscular block (NMB) affects Intra-abdominal pressure (IAP) and cognition in Prostate cancer (PC) patients with Robotic-assisted laparoscopic radical prostatectomy (RALRP) remains unclear. Here we aimed to compare the effects of deep and moderate NMB on the IAP, inflammation, and cognition. Methods: The Moderate neuromuscular block (MNMB) group (N = 44) and Deep neuromuscular block (DNMB) group (N = 47) were recruited. Intra-abdominal pressure was adjusted to meet RALRP requirements. The expression of pro-inflammatory factors was measured by ELISA. MMSE scores were recorded before the operation, 1 day and 1 week after the operation. Results: Significant decreases in IAP (p < 0.001) and IL-1β, IL-6, TNF-a, and S-100β (p ≤ 0.01) expressions were found in the DNMB group. The MMSE score in the DNMB group was higher than that in the MNMB group on day one (p = 0.046). The incidence of nausea and vomiting was lower in the DNMB group than that in the MNMB group (p = 0.013). Conclusions: DNMB reduces IAP and inflammation and improves post-operative cognitive functions in PC patients with RALRP.