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

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-1 beta, IL-6, TNF-a, and S-100 beta (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.