The Impacts of Surgical Visibility Through Deep Neuromuscular Blockade on Intraocular Pressure in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy

Not Applicable

Completed

Interventions: Procedure: deep neuromuscular blockade
Procedure: moderate neuromuscular blockade
Drug: Rocuronium
Drug: Atracurium
Drug: Sugammadex
Drug: Neostigmine

Brief Summary: Intraocular pressure is significantly increase during robot-assisted laparoscopic radical prostatectomy which is performed in a steep trendelenburg position at prolonged times of pneumoperitoneum. Therefore investigators decided to evaluate the impacts of surgical visibility through deep neuromuscular blockade on intraocular pressure in patients undergoing Robot-Assisted Laparoscopic Radical Prostatectomy.

Recruitment & Eligibility

Inclusion Criteria

ASA class I-II
obtaining written informed consent from the parents
aged over 50 years who were undergoing robot- assisted laparoscopic prostatectomy

Exclusion Criteria

eye surgery previously
unstable angina or congestive heart failure
concomitant eye disease (glaucoma, diabetic retinopathy, cataract, retinal detachment)
high intraocular pressure over 30mmHg after screening test.
uncontrolled hypertension (diastolic bp>110mmHg)
coagulopathy
asthma
hepatic failure
renal failure(creatinine clearance < 30 ml/min)
drug hyperactivity
neurological or psychiatric illnesses
mental retardation
patients who can't read the consent form due to illiterate or foreigner
previous malignant hyperthermia Hx
drug medication which interact with muscle relaxant (anti-convulsant, certain antibiotics, magnesium etc)
BMI > 30kg/m2

Arm && Interventions

Group	Intervention	Description
Deep neuromuscular blockade	deep neuromuscular blockade	Deep neuromuscular blockade
moderate neuromuscular blockade	moderate neuromuscular blockade	moderate neuromuscular blockade
Deep neuromuscular blockade	Rocuronium	Deep neuromuscular blockade
Deep neuromuscular blockade	Sugammadex	Deep neuromuscular blockade
moderate neuromuscular blockade	Neostigmine	moderate neuromuscular blockade
moderate neuromuscular blockade	Atracurium	moderate neuromuscular blockade

Primary Outcome Measures

Name	Time	Method
Maximum Intraocular Pressure During RALRP Under Deep Neuromuscular Blockade	Maximum intraocular pressure was measured at 60 minutes after CO2 pneumoperitoneum in the ST position	maximum intraocular pressure during RALRP under deep neuromuscular blockade after being positioned in the steep Trendelenburg position with CO2 pneumoperitoneum under deep neuromuscular blockade

Secondary Outcome Measures

Name	Time	Method
Overall Surgical Condition	At the end of the Steep trendelenburg position, an average of 1 hour	overall surgical conditions using the 5-point rating scale as previously described: Grade 5 (optimal), optimal surgical conditions; grade 4 (good), nonoptimal conditions, but an intervention is not required; grade 3 (acceptable), wide surgical view, but an intervention can improve surgical conditions, grade 2 (poor), inadequate conditions, there is a visible view, but an intervention is necessary to ensure acceptable surgical conditions; grade 1 (extremely poor), inability to perform surgery; therefore, intervention is necessary.