Postoperative Respiratory Complications: Are They Reduced When Using Sugammadex in Reversal of Rocuronium Induced Neuromuscular Block Compared to Neostigmine in Patients Undergoing Uvulopalatopharengeoplasty
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- Category: Vol. 85, June 2017
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Postoperative Respiratory Complications: Are They Reduced When Using Sugammadex in Reversal of Rocuronium Induced Neuromuscular Block Compared to Neostigmine in Patients Undergoing Uvulopalatopharengeoplasty, HODA H. OKASHA, EMAN A. FOUAD, MARWA S. ZAYED and DINA M. MOHAMMED
Abstract
Background: Obstructive sleep apnea syndrome (OSAS) is a serious medical problem. Perioperative complications of uvuloplatoplasty included difficult intubation, reintubation, postoperative pulmonary edema, postoperative desaturations, and/or need for continuous positive airway pressure. The recent introduction of sugammadex, has raised hopes to finally overcome the problem of residual neuromuscular blockade.
Methods: 40 patients who had been enrolled in the study. 20 patients as group (A) [sugammadex group] and the other 20 patients as group (B) [neostigmine group], This prospec-tive,randomized, double-blinded, clinical trial study was designed to show the efficacy of reversal of neuromuscular blockade produced by rocuronium either by neostigmine or sugammadex.
At the end of surgery, any adverse events after adminis-tration of drugs, e.g. drug allergy, were reported. Hemodynamic instability in the form of arrhythmias or blood pressure changes and oxygen saturation were assessed in postoperative anes-thesia care unit (PACU) and any abnormality was reported.
Patients were assessed at 1, 6, 12 hours for nausea severity, vomiting frequency and number of antiemetic doses. Also, postoperative respiratory complications were assessed by Postoperative Respiratory System Evaluation Scoring (PRSES).
Primary outcome is to detect postoperative respiratory complications. Adverse events were recorded (cardiac arrhyth-mias, inability to extubate, nausea and vomiting).
Results: Postoperatively respiratory complications [as-sessed by PRSES] as primary outcome for the study. There was significant difference between the 2 groups. The patients were assessed for drug allergy, hemodynamic stability, oxygen saturation and by comparing both groups, there were no significant differences detected. Also, the severity of postop-erative nausea and vomiting and the need for antiemetic administration were assessed and there were no significant differences detected between the 2 groups.
Conclusion: In the current study, we aimed to compare the efficacy of reversal of neuromuscular blockade produced by rocuronium either by neostigmine or sugammadex on postoperative respiratory complications in patients undergoing uvulopalatopharyngeoplasty. We found a statistically significant difference between neostigmine and sugammadex postoperative respiratory complications [assessed by Postoperative respira-tory system evaluation score]. However there was no statisti-cally significant difference regarding hemodynamic stability or postoperative nausea and vomiting.