Half-Dose Sugammadex After Neostigmine Versus Neostigmine as a Routine Reversal Agent: A Pilot Randomized Trial

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dc.authoridBaysal, Ayse/0000-0002-1487-7407
dc.contributor.authorBaysal, Ayse
dc.contributor.authorSagiroglu, Gonul
dc.contributor.authorDogukan, Mevlut
dc.contributor.authorOzkaynak, Ismail
dc.date.accessioned2024-06-12T11:15:46Z
dc.date.available2024-06-12T11:15:46Z
dc.date.issued2022
dc.departmentTrakya Üniversitesien_US
dc.description.abstractPurpose: 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.en_US
dc.identifier.doi10.1016/j.jopan.2021.09.009
dc.identifier.endpage332en_US
dc.identifier.issn1089-9472
dc.identifier.issn1532-8473
dc.identifier.issue3en_US
dc.identifier.pmid35153119en_US
dc.identifier.scopus2-s2.0-85124393803en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage326en_US
dc.identifier.urihttps://doi.org/10.1016/j.jopan.2021.09.009
dc.identifier.urihttps://hdl.handle.net/20.500.14551/24069
dc.identifier.volume37en_US
dc.identifier.wosWOS:000836547900011en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofJournal Of Perianesthesia Nursingen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectSugammadexen_US
dc.subjectNeostigmineen_US
dc.subjectNeuromuscular Blockadeen_US
dc.subjectResidual Neuromuscular Blockadeen_US
dc.subjectPostoperative Complicationsen_US
dc.subjectResidual Neuromuscular Blockadeen_US
dc.subjectAdverse Respiratory Eventsen_US
dc.subjectPulmonary Complicationsen_US
dc.subjectBlocking-Agentsen_US
dc.subjectCare-Uniten_US
dc.subjectMulticenteren_US
dc.subjectRisken_US
dc.subjectCurarizationen_US
dc.subjectAnesthesiaen_US
dc.subjectImpacten_US
dc.titleHalf-Dose Sugammadex After Neostigmine Versus Neostigmine as a Routine Reversal Agent: A Pilot Randomized Trialen_US
dc.typeArticleen_US

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