Sugammadex versus neostigmine in pediatric patients: a prospective randomized study

Background and objectives: Acetylcholinesterase inhibitors may cause postoperative residual curarization when they are used for reversal of neuromuscular blockade. Sugammadex reverses neuromuscular blockade by chemical encapsulation and is not associated with the side effects that may occur with the...

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Main Authors: Turhan Kara, Ozgur Ozbagriacik, Hacer Sebnem Turk, Canan Tulay Isil, Ozan Gokuc, Oya Unsal, Emrah Seyhan, Sibel Oba
Format: Article
Language:English
Published: Sociedade Brasileira de Anestesiologia 2014-12-01
Series:Revista Brasileira de Anestesiologia
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000600400&lng=en&tlng=en
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author Turhan Kara
Ozgur Ozbagriacik
Hacer Sebnem Turk
Canan Tulay Isil
Ozan Gokuc
Oya Unsal
Emrah Seyhan
Sibel Oba
author_facet Turhan Kara
Ozgur Ozbagriacik
Hacer Sebnem Turk
Canan Tulay Isil
Ozan Gokuc
Oya Unsal
Emrah Seyhan
Sibel Oba
author_sort Turhan Kara
collection DOAJ
description Background and objectives: Acetylcholinesterase inhibitors may cause postoperative residual curarization when they are used for reversal of neuromuscular blockade. Sugammadex reverses neuromuscular blockade by chemical encapsulation and is not associated with the side effects that may occur with the use of anticholinesterase agents. Because of increased outpatient surgical procedures postoperative residual curarization and rapid postoperative recovery have a greater importance in the pediatric patient population. The aim of this study was to compare the efficacy of sugammadex and neostigmine on reversing neuromuscular blockade in pediatric patients undergoing outpatient surgical procedures. Methods: 80 patients, aged 2-12 years, scheduled for outpatient surgery were enrolled in this randomized prospective study. Neuromuscular blockade was achieved with 0.6 mgkg−1 rocuronium and monitorized with train-of-four. Group RN (n = 40) received 0.03 mgkg−1 neostigmine, Group RS (n = 40) received 2 mgkg−1 sugammadex for reversal of rocuronium. Extubation time (time from the reversal of neuromuscular blockade to extubation), train-of-four ratio during this time, time to reach train-of-four > 0.9, and probable complications were recorded. Results: There was no significant difference between the patients' characteristics. Extubation time and time to reach train-of-four > 0.9 were significantly higher in Group RN (p = 0.001, p = 0.002). Train-of-four at the time of neostigmine/sugammadex injection in Group RN were significantly higher than in the RS group (p = 0.020). Extubation train-of-four ratio was significantly lower in Group RN (p = 0.002). Conclusion: Sugammadex provides safer extubation with a shorter recovery time than neostigmine in pediatric patients undergoing outpatient surgical procedures.
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spelling doaj.art-0124c95c53ef4036913f19abad9e78402022-12-22T00:31:05ZengSociedade Brasileira de AnestesiologiaRevista Brasileira de Anestesiologia1806-907X2014-12-0164640040510.1016/j.bjane.2014.03.001S0034-70942014000600400Sugammadex versus neostigmine in pediatric patients: a prospective randomized studyTurhan KaraOzgur OzbagriacikHacer Sebnem TurkCanan Tulay IsilOzan GokucOya UnsalEmrah SeyhanSibel ObaBackground and objectives: Acetylcholinesterase inhibitors may cause postoperative residual curarization when they are used for reversal of neuromuscular blockade. Sugammadex reverses neuromuscular blockade by chemical encapsulation and is not associated with the side effects that may occur with the use of anticholinesterase agents. Because of increased outpatient surgical procedures postoperative residual curarization and rapid postoperative recovery have a greater importance in the pediatric patient population. The aim of this study was to compare the efficacy of sugammadex and neostigmine on reversing neuromuscular blockade in pediatric patients undergoing outpatient surgical procedures. Methods: 80 patients, aged 2-12 years, scheduled for outpatient surgery were enrolled in this randomized prospective study. Neuromuscular blockade was achieved with 0.6 mgkg−1 rocuronium and monitorized with train-of-four. Group RN (n = 40) received 0.03 mgkg−1 neostigmine, Group RS (n = 40) received 2 mgkg−1 sugammadex for reversal of rocuronium. Extubation time (time from the reversal of neuromuscular blockade to extubation), train-of-four ratio during this time, time to reach train-of-four > 0.9, and probable complications were recorded. Results: There was no significant difference between the patients' characteristics. Extubation time and time to reach train-of-four > 0.9 were significantly higher in Group RN (p = 0.001, p = 0.002). Train-of-four at the time of neostigmine/sugammadex injection in Group RN were significantly higher than in the RS group (p = 0.020). Extubation train-of-four ratio was significantly lower in Group RN (p = 0.002). Conclusion: Sugammadex provides safer extubation with a shorter recovery time than neostigmine in pediatric patients undergoing outpatient surgical procedures.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000600400&lng=en&tlng=enSugammadexNeostigminaPediátrico
spellingShingle Turhan Kara
Ozgur Ozbagriacik
Hacer Sebnem Turk
Canan Tulay Isil
Ozan Gokuc
Oya Unsal
Emrah Seyhan
Sibel Oba
Sugammadex versus neostigmine in pediatric patients: a prospective randomized study
Revista Brasileira de Anestesiologia
Sugammadex
Neostigmina
Pediátrico
title Sugammadex versus neostigmine in pediatric patients: a prospective randomized study
title_full Sugammadex versus neostigmine in pediatric patients: a prospective randomized study
title_fullStr Sugammadex versus neostigmine in pediatric patients: a prospective randomized study
title_full_unstemmed Sugammadex versus neostigmine in pediatric patients: a prospective randomized study
title_short Sugammadex versus neostigmine in pediatric patients: a prospective randomized study
title_sort sugammadex versus neostigmine in pediatric patients a prospective randomized study
topic Sugammadex
Neostigmina
Pediátrico
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942014000600400&lng=en&tlng=en
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