Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2021.62.606
Comparison of recovery after sugammadex or neostigmine reversal of rocuronium in geriatric patients undergoing spine surgery: a randomized controlled trial
Boris Mraovic
orcid.org/0000-0003-4019-4084
; Department of Anesthesiology and Perioperative Medicine, University of Missouri Columbia, Columbia, MO, USA
Noah J. Timko
orcid.org/0000-0002-3824-2633
; Department of Anesthesiology and Perioperative Medicine, University of Missouri Columbia, Columbia, MO, USA
Theodore J. Choma
; Department of Orthopaedic Surgery, University of Missouri Columbia, Columbia, MO, USA
Sažetak
Aim To evaluate the effect of sugammadex compared with
neostigmine on speed and quality of recovery after rocuronium neuromuscular blockade (NMB) in geriatric patients
undergoing posterior lumbar spine surgery.
Methods This randomized controlled study at a tertiary
academic medical center involved 40 patients (age ≥65
years, ASA PS II/III) scheduled for elective surgery under
general anesthesia. Patients were randomized to sugammadex or neostigmine for reversal of moderate NMB with
rocuronium. The primary outcome was recovery time from
NMB after surgery to a train-of-four (TOF) ratio ≥0.9 measured at the adductor pollicis (TOF-Watch®
SX). Secondary outcomes included hemodynamic change after administration of reversal agent (heart rate, blood pressure,
dysrhythmia), time to extubation, pain medication requirement, time to first ambulation, and length of postanesthesia care unit (PACU) and total hospital stay.
Results Sugammadex (4±2.2 min) compared with neostigmine reversal (26.3±17.5 min) was on average 22
min faster (95% CI 14.1-30.5; P≤0.001) with less variability
(range 2-11 min vs 5-72 min). The groups significantly differed in time for tracheal extubation, response to verbal
commands (open eyes, squeeze hand, lift head), and operating room exit. However, they had similar PACU stay, time
to first ambulation, total hospital stay, postoperative pain,
and opioid use. Sugammadex had less hemodynamic variability than neostigmine. No patient developed treatmentemergent dysrhythmias.
Conclusion Sugammadex reversal significantly hastened
NMB recovery compared with neostigmine reversal in geriatric patients. It significantly decreased operating room
time but not PACU time or hospital stay
Ključne riječi
Hrčak ID:
278871
URI
Datum izdavanja:
23.12.2021.
Posjeta: 390 *