Half-Dose Sugammadex After Neostigmine Versus Neostigmine as a Routine Reversal Agent: A Pilot Randomized Trial
Küçük Resim Yok
Tarih
2022
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Elsevier Science Inc
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Purpose: The use of sugammadex at a lower dose after a routine reversal dose of neostigmine may prevent residual neuromuscular blockade (rNMB). Our goal was to investigate the effects of the use of half-dose sugammadex for reversing rNMB after administration of neostigmine, and compare these effects to a routine full-dose of neostigmine. Design: Prospective, single-blinded, randomized trial. Methods: Ninety-eight patients having lower abdominal tumor resection surgery under general anesthesia were randomized into two groups. Group N (Neostigmine) (n = 48) patients received standard reversal dose of intravenous neostigmine 0.05 mg/kg and atropine 0.02 mg/kg before extubationl Group N + S (Neostigmine + Sugammadex) (n = 50) patients received 1 mg/kg of intravenous sugammadex three minutes after a standard neostigmine reversal dose. The primary end-point was the incidence of a train-of-four (TOF) ratio less than 0.9 at tracheal extubation. Secondary end-points were periods between the start of administration of reversal agents and extubation or operating room discharge in minutes to achieve recovery of TOF ratio < 0.9 to 0.7 and TOF ratio >= 0.9. Findings: The demographic data were not different between the two groups (P >.005). The incidence of rNMB presented as TOF ratio < 0.9 to 0.7 was present in 52% of Group N patients compared to 8% in Group N + S patients (P <.0001). The time to recovery between administering reversal and extubation as well as operating room discharge in Group N were; 18.52 +/- 6.34 minutes and 23.27 +/- 6.95 minutes, respectively, whereas; in Group N + S, they were; 12.86 +/- 5.05 and 17.82 +/- 4.99 minutes, respectively. (P <.0001, P <.0001, respectively). Adverse events were similar between groups (P >.05). Conclusions: A half-dose sugammadex (1 mg/kg) after full-dose reversal of neostigmine provides a lower incidence of rNMB and shorter recovery times as compared to full-dose neostigmine reversal agent. This practice is safe and effective in case of rNMB. (C) 2021 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.
Açıklama
Anahtar Kelimeler
Sugammadex, Neostigmine, Neuromuscular Blockade, Residual Neuromuscular Blockade, Postoperative Complications, Residual Neuromuscular Blockade, Adverse Respiratory Events, Pulmonary Complications, Blocking-Agents, Care-Unit, Multicenter, Risk, Curarization, Anesthesia, Impact
Kaynak
Journal Of Perianesthesia Nursing
WoS Q Değeri
Q3
Scopus Q Değeri
Q1
Cilt
37
Sayı
3
