Deep neuromuscular block with pipecuronium in patients undergoing laparoscopic surgery — A prospective case series
Authors' conclusion
Pipecuronium is a rational alternative when deep neuromuscular block is necessary, because of its long-acting neuromuscular blocking effect that may be antagonized quickly and safely with sugammadex.
Study context
- Population
- Adults awaiting cardiac surgery or heart transplantation requiring non-elective laparoscopic abdominal surgery
- Participants
- 10 adults
- Outcome
- Feasibility of maintaining low intraabdominal pressures during pipecuronium-induced deep block (post-tetanic count ≥1, TOF count = 0)
Main finding
As reported in the abstract
Intraabdominal pressure during pneumoperitoneum
Mean intraabdominal pressure during pneumoperitoneum, mmHg (mean ± SD)
8.1 ± 1.1
Observational data: associations, not effects.
Further findings
Onset time of pipecuronium induction dose 0.09 mg/kg
- Onset time, min (median, 25-75% IQR)
- 5.3 (2.3-6.3)
Duration of deep block
- Deep block maintained, min (mean ± SD)
- 51.2 ± 19.7
Top-up pipecuronium doses
- Patients needing top-up doses
- 5
- Time after first dose, min (mean ± SD)
- 56.0 ± 28.1
NMB depth at end of surgery
- Deep block, post-tetanic count
- 0-6
Recovery after sugammadex 2 mg/kg
- Time to TOFR ≥0.9, min (mean ± SD)
- 3.5 ± 1.6
- Time to TOFR = 1.0, min (mean ± SD)
- 4.3 ± 1.2
Safety
- No significant change in heart rate, beats/min
- 0.0, −2.6 to 0
Original publication
Deep neuromuscular block with pipecuronium in patients undergoing laparoscopic surgery — A prospective case series. Anaesth Crit Care Pain Med. Published 19 February 2025. doi:10.
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