Reversal of Rocuronium Induced Neuromuscular Block with Sugammadex or Neostigmine in Patients Undergoing Uvulopalatopharyngoplasty
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- Category: Vol. 85, June 2017
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Reversal of Rocuronium Induced Neuromuscular Block with Sugammadex or Neostigmine in Patients Undergoing Uvulopalatopharyngoplasty, HODA H. OKASHA, EMAN A. FOUAD, MARWA S. ZAYED and DINA M. MOHAMMED
Abstract
Background: Obstructive sleep apnea syndrome (OSAS) is now considered to be a major public health concern, with significant morbidity and mortality. One of the most common surgical procedures used in OSAS patients is uvulo-palatopharyngoplasty (UPPP). The recent introduction of sugammadex, allows the rapid and complete reversal of especially rocuronium-induced neuromuscular blockade.
Methods: 40 patients who are candidated to undergo UPPP had been enrolled in the study. 20 patients as group (A) [sugammadex group] and the other 20 patients as group (B) [neostigmine group], This prospective, randomized, double-blinded, clinical trial study was designed to compare the efficacy of reversal of neuromuscular blockade induced by rocuronium either by neostigmine or sugammadex.
At the end of surgery, all patients will receive reversal of neuromuscular blockade either by sugammadex 4mg/Kg regarding group (A) or by neostigmine 0.05mg/Kg and atropine 0.02mg/Kg for group (B). Efficacy of the reversal will be assessed by nerve stimulator.
The Primary outcome was to Compare between reversal time of neostigmine and sugammadex [time between admin-istration of the drug and visual loss of fade (train of four ratio of 0.9)].
The secondary outcome was to detect intraoperative complications and to detect successful extubation, reintubation, and failure of extubation in both groups.
Results: Comparison between reversal time of neostigmine and sugammadex was assessed as primary outcome for the study and there was a significant difference between the 2 groups. The patients were also assessed for intraoperative complications and intraoperative laryngeal view, there were no significant differences detected. Also, there was no signif-icant difference detected regarding successful extubation, reintubation, and failure of extubation in both groups.
Conclusion: By comparing the efficacy of reversal of neuromuscular blockade produced by rocuronium either by neostigmine or sugammadex using train of four ratio (TOF), we found a statistically significant difference between neo-stigmine and sugammadex group. However there was no statistically significant difference regarding intraoperative complications, intraoperative laryngeal view, successful extubation, reintubation, and failure of extubation in both groups.