[Controlled myorelaxation in patients with aldosteroma]

Purpose of the study was to develop techniques of controlled myorelaxation during surgeries in patients with aldosteroma. 46 patients were involved in the study. Adrenalectomy was performed by videoendoscopy from retroperitoneal access. All patients were operated under general anaesthesia with sevoflurane with obligate monitoring of neuromuscular conduction (NMC). Patients were divided into 4 groups. Myorelaxation in patients of the group 1 (n = 14) was performed by continuous infusion of 0.4 mg/kg/hr rocuronium bromide (esmeron). Myorelaxation in patients of groups 2 (n = 11), 3 (n = 11) and 4 (n = 10) was performed by bolus administration of 0.15 mg/kg/hr esmeron. Patients of groups 1 and 2 were not decurarized. Decurarization in the group 3 was performed by proserin and in the group 4 by sugammadex. In patients of the group 1 esmeron consumption was minimal due to continuous infusion of the drug. Time of neuromuscular blockade recovery (TOF 0.9) was longer than 19 min. Worst data of neuromuscular blockade recovery accrued in the group 2. In patients of the group 3 time of neuromuscular blockade recovery (TOF 0.9) reduced 2.5-3 times in comparison with groups 1 and 2. The use of sugammadex in the group 4 provided almost 4.7 times faster neuromuscular blockade recovery than proserin administration. Controlled myorelaxation in patients with aldosteroma is possible when monitoring of neuromuscular conduction is provided. Infusion administration of esmeron provides decreasing of its consumption and high quality of myorelaxation. Sugammadex administration provides 4.7 times faster neuromuscular blockade recovery (TOF 0.9) than proserin administration without risk of neuromuscular block reverse.