Comparison of sugammadex and neostigmine in short term surgery Kısa süreli cerrahide sugammadeks ile neostigminin karşılaştırılması


Koç F., TURAN G., Subaşı D., EKİNCİ O.

Journal of Clinical and Analytical Medicine, cilt.6, sa.1, ss.41-45, 2015 (Scopus, TRDizin)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 6 Sayı: 1
  • Basım Tarihi: 2015
  • Doi Numarası: 10.4328/jcam.1694
  • Dergi Adı: Journal of Clinical and Analytical Medicine
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.41-45
  • Anahtar Kelimeler: Sugammadex, Neostigmine, Neuromuscular Blockade
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Aim: This study compared the efficacy and cost effectivines of sugamma-dex and neostigmine for reversal of neuromuscular blockade induced by ro-curonium for short term elective surgery. Material and Method: After written informed consent, 33 patients aged 18–65, ASA I-III, who were undergoing short term surgery (<90 min) were randomly selected and divided into two groups (Group Sugamadex, n=16; group Neostigmine, n=17). All patients were given 1,5 μg kg-1 fentanyl, 5-7 mgkg-1 thiopental, 0,6 mg kg-1 ro-curonium for anaesthesia induction. Anaesthetic maintenance was ensured through 50% O2-N2O and 1% sevoflurane. Neuromuscular blockade was monitored using acceleromyography and a train-of-four (TOF) mode of stim-ulation. During surgery maintenance doses of 0.1-0.2 mgkg-1 rocuronium were administered according to reappearance of the third response of the TOF. Patients were given sugammadex 2 mg kg_1(group S) or neostigmine 50 μg kg_1 (with atropine 20 μg kg_1) (group N) at reappearance of the second response of the TOF after the last dose of rocuronium in the end of the surgery. Results: Demographic properties were similar in the two groups. Time to recovery of the TOF ratio of 0.9 and extubation time after sugam-madex compared with neostigmine were significantly shorter, being 2.3 ± 0.9 versus 9.4 ± 2.7 min and 6.6 ± 1.6 versus 12.9 ± 2 (P<0.001). The costs were higher in group S (71.2 ± 9.8 $) than group N (1.7 ± 0.2 $) per patient (p<0.001). Discussion: Recovery of neuromuscular function after rocuronium to a TOF ratio of 0.9 was faster with 2mg kg_1 sugammadex when com-pared with 50 μg kg_1 neostigmine, while sugammadex was the more ex-pensive then neostigmine.