Objective: To explore the effect of rocuronium on gastric insufflation related to facemask ventilation in general anaesthesia patients.
Methods: Eighty patients from June to October 2015 undergoing elective operation under general anaesthesia at Ningbo NO.2 Hospital , ASA I or II grade, aged 18-65, were enrolled in this study and divided into two groups (n=40): Group R (rocuronium) and Group C (for control). Facemask pressure-controlled ventilation was started after general anaesthesia induced with propofol and remifentanil for a 2 min period while gastric insufflation was detected by ultrasonography of the antrum. The cross-sectional antral area (CSA) was measured using ultrasonography before and after facemask ventilation. Respiratory parameters were also recorded.
Results: Compared to the antral area before FMV, the CSA significantly increased in group R and C after FMV [post-FMV:(579.5 ± 167.3), (508.1 ± 112.2)mm²; pre-FMV(479.4 ± 110.2), (451.2 ± 103.4) mm²; t=5.938, 4.302, P<0.001]. All the patients were divided into four subgroups according to the gastric insufflation (R+, R-, C +, C-) and there were significant increases in the values of CSA before and after FMV in groups R+ and C+[post-FMV(647.7 ± 150.6), (546.2 ± 121.1) mm²; pre-FMV (501.2 ± 113.6), (422.6 ± 101.5) mm²; t=7.885, 8.719, P<0.001], without any significant increase in groups R- and C-[post-FMV(496.0 ± 150.9), (489.8 ± 105.1) mm²; pre-FMV (452.9 ± 102.8), (465.0 ± 103.3) mm²; t=1.793, 1.663, P>0.05]. Compared with the group R- , the CSA of group R+ significantly increased before and after FMV[group R+ (146.6 ± 87.2) mm²; group R- (43.1 ± 102.1) mm²; t=3.458, P<0.001]; compared with the group C- , the CSA of group C+ significantly increased before and after FMV [group C+ (123.6 ± 51.1) mm²; group C- (24.8 ± 77.4) mm²; t=4.172, P<0.001]; there was no significant difference between the difference value of CSA in groups R+ and C+ before and after FMV (t=0.983, P>0.05). The incidence of gastric insufflation was 55% and 32.5% in group R and C, respectively (χ² =4.114, P<0.05). There was no significant difference in respiratory parameters between group R and C.
Conclusion: The study suggests that rocuronium may promote gastric insufflation related to facemask ventilation (15 cmH₂O PCV)in general anaesthesia patients.