Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community Hospital
Purpose: The purpose of this study was to evaluate the impact of sugammadex on operating room (OR) times versus neostigmine in patients recovering from rocuronium or vecuronium induced neuromuscular blockade. Methods: This retrospective cohort study evaluated patients 18 years or older with an Am...
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| Format: | Article |
| Language: | English |
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University of Minnesota Libraries Publishing
2020-08-01
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| Series: | INNOVATIONS in Pharmacy |
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| Online Access: | https://pubs.lib.umn.edu/index.php/innovations/article/view/3329 |
| _version_ | 1818473236582629376 |
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| author | Julie John Greg Perry Jeremie Perry Viktoria Guttenberg Nicole Asonganyi Sana Laheji Jaffar Raza Ronald G Hall |
| author_facet | Julie John Greg Perry Jeremie Perry Viktoria Guttenberg Nicole Asonganyi Sana Laheji Jaffar Raza Ronald G Hall |
| author_sort | Julie John |
| collection | DOAJ |
| description | Purpose: The purpose of this study was to evaluate the impact of sugammadex on operating room (OR) times versus neostigmine in patients recovering from rocuronium or vecuronium induced neuromuscular blockade.
Methods: This retrospective cohort study evaluated patients 18 years or older with an American Society of Anesthesiologists (ASA) physical status of I-III who received sugammadex or neostigmine (January- October 2017) for reversal of rocuronium or vecuronium at a 500 bed, community hospital. Patients who were pregnant or breastfeeding were excluded. The primary outcome measure was the time from sugammadex or neostigmine administration to OR exit. The primary outcome was evaluated using a linear regression model adjusting for inpatient procedures, age, sex, body mass index, and ASA score. Secondary outcomes included the incidence of bradycardia as well as nausea and vomiting.
Results: The baseline characteristics of the patients in the cohort (sugammadex=134, neostigmine=143) were similar. The median time from drug administration to OR exit was similar for neostigmine and sugammadex (16 vs. 15.5 minutes, p=0.11). Sugammadex had a statistically significant reduction in time from drug administration to OR exit (coefficient -2.7 minutes, 95% confidence interval -5.2 to -0.2 minutes) in the multivariable linear regression model. Sugammadex had lower rates of bradycardia (5.6 vs. 2.2%) or nausea and vomiting (18 vs. 11%) that did not reach statistical significance.
Conclusions: Sugammadex had statistically shorter OR exit times after drug administration in the cohort. The mean 2.7 minute benefit is unlikely to be clinically meaningful and limits its application in practice unless larger cohorts detect a benefit due to a significant reduction.in.adverse.events.
Original Research |
| first_indexed | 2024-04-14T04:20:44Z |
| format | Article |
| id | doaj.art-5e78a2837f9b4682866e68b148cb1beb |
| institution | Directory Open Access Journal |
| issn | 2155-0417 |
| language | English |
| last_indexed | 2024-04-14T04:20:44Z |
| publishDate | 2020-08-01 |
| publisher | University of Minnesota Libraries Publishing |
| record_format | Article |
| series | INNOVATIONS in Pharmacy |
| spelling | doaj.art-5e78a2837f9b4682866e68b148cb1beb2022-12-22T02:12:32ZengUniversity of Minnesota Libraries PublishingINNOVATIONS in Pharmacy2155-04172020-08-0111310.24926/iip.v11i3.3329Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community HospitalJulie John0Greg Perry1Jeremie Perry2Viktoria Guttenberg3Nicole Asonganyi4Sana Laheji5Jaffar Raza6Ronald G Hall7Hendrick Medical CenterHendrick Medical CenterHendrick Medical CenterTexas Tech University Health Sciences Center, School of PharmacyTexas Tech University Health Sciences Center, School of PharmacyTexas Tech University Health Sciences Center, School of PharmacyTexas Tech University Health Sciences Center, School of PharmacyTexas Tech University Health Sciences Center, School of PharmacyPurpose: The purpose of this study was to evaluate the impact of sugammadex on operating room (OR) times versus neostigmine in patients recovering from rocuronium or vecuronium induced neuromuscular blockade. Methods: This retrospective cohort study evaluated patients 18 years or older with an American Society of Anesthesiologists (ASA) physical status of I-III who received sugammadex or neostigmine (January- October 2017) for reversal of rocuronium or vecuronium at a 500 bed, community hospital. Patients who were pregnant or breastfeeding were excluded. The primary outcome measure was the time from sugammadex or neostigmine administration to OR exit. The primary outcome was evaluated using a linear regression model adjusting for inpatient procedures, age, sex, body mass index, and ASA score. Secondary outcomes included the incidence of bradycardia as well as nausea and vomiting. Results: The baseline characteristics of the patients in the cohort (sugammadex=134, neostigmine=143) were similar. The median time from drug administration to OR exit was similar for neostigmine and sugammadex (16 vs. 15.5 minutes, p=0.11). Sugammadex had a statistically significant reduction in time from drug administration to OR exit (coefficient -2.7 minutes, 95% confidence interval -5.2 to -0.2 minutes) in the multivariable linear regression model. Sugammadex had lower rates of bradycardia (5.6 vs. 2.2%) or nausea and vomiting (18 vs. 11%) that did not reach statistical significance. Conclusions: Sugammadex had statistically shorter OR exit times after drug administration in the cohort. The mean 2.7 minute benefit is unlikely to be clinically meaningful and limits its application in practice unless larger cohorts detect a benefit due to a significant reduction.in.adverse.events. Original Researchhttps://pubs.lib.umn.edu/index.php/innovations/article/view/3329sugammadex, neostigmine, neuromuscular blocker reversal, anesthesia, surgery |
| spellingShingle | Julie John Greg Perry Jeremie Perry Viktoria Guttenberg Nicole Asonganyi Sana Laheji Jaffar Raza Ronald G Hall Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community Hospital INNOVATIONS in Pharmacy sugammadex, neostigmine, neuromuscular blocker reversal, anesthesia, surgery |
| title | Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community Hospital |
| title_full | Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community Hospital |
| title_fullStr | Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community Hospital |
| title_full_unstemmed | Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community Hospital |
| title_short | Impact of Neostigmine and Sugammadex on Time to Leaving the Operating Room in a Community Hospital |
| title_sort | impact of neostigmine and sugammadex on time to leaving the operating room in a community hospital |
| topic | sugammadex, neostigmine, neuromuscular blocker reversal, anesthesia, surgery |
| url | https://pubs.lib.umn.edu/index.php/innovations/article/view/3329 |
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