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http://dx.doi.org/10.24304/kjcp.2018.28.2.101

Comparison of Sugammadex and Neostigmine on First Spontaneous Breathing and Adverse Effects for Laparoscopic Cholecystectomy  

Park, HyunSuk (Graduate School of Converging Clinical and Public Health, Ewha Womans University)
Park, Moon Soo (Department of Orthopaedic Surgery Hallym University Sacred Heart Hospital and, Medical College of Hallym University)
Kim, Min Jung (Department of Pharmacy, Seoul National University Hospital)
Kim, Kwi Suk (Department of Pharmacy, Seoul National University Hospital)
Cho, Yoon Sook (Department of Pharmacy, Seoul National University Hospital)
Bae, Seng Sim (Department of Nursing, Seoul National University Hospital)
Rhie, Sandy Jeong (Graduate School of Converging Clinical and Public Health, Ewha Womans University)
Publication Information
Korean Journal of Clinical Pharmacy / v.28, no.2, 2018 , pp. 101-106 More about this Journal
Abstract
Objective: The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy. Methods: This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group). Results: The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p<0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p<0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p<0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p<0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p<0.05). Conclusion: In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.
Keywords
Sugammadex; neostigmine; muscle relaxants; laparoscopic cholecystectomy; antiemetic;
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1 Juvin P, Vadam C, Malek L, et al. Postoperative recovery after desflurane, propofol, or isoflurane anesthesia among morbidly obese patients: a prospective, randomized study. Anesth Analg 2000;91:714-9.   DOI
2 Ozkose Z, Ercan B, Unal Y, et al. Inhalation versus total intravenous anesthesia for lumbar disc herniation. J Neurosurg Anesthesiol 2001; 13(4):296-302.   DOI
3 Kusha N, Dewan R, Akshaya N, et al. Sugammadex: A revolutionary drug in Neuromuscular pharmacology Anesth Essays Res 2013;7(3):302-6.   DOI
4 Sacan O, White PF, Tufanogullari B, et al. Sugammadex reversal of rocuronium-induced neuromuscular blockade: A comparison with neostigmine - glycopyrrolate and edrophonium-atropine. Anesth Analg 2007;104:569-74.   DOI
5 Jones RK, Caldwell JE, Brull SJ, et al. Reversal of profound rocuronium - induced blockade with sugammadex: A randomized comparison with neostigmine. Anesthesiology 2008;109:816-24.   DOI
6 Naguib M, Kopman AF, Ensor JE. Neuromuscular monitoring and postoperative residual curarisation: a meta-analysis. Br J Anaesth 2007;98:302-16.   DOI
7 Zerrin O, Bilge E, Yusuf U. Inhalation versus total intravenous anesthesia for lumbar disc herniation. J Neurosurg Anesthesiol 2001;13(4):296-302.   DOI
8 Onur K, Selim T, Cagla O. Comparison of sugammadex and conventional reversal on postoperative nausea and vomiting: a randomized, blind trial. J Clin Anesth 2015;27:51-6.   DOI
9 Gan TJ, Diemunsch P, Habib AS, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014;118(1):85-113.   DOI
10 Badaoui R, Cabaret A, Alami Y, et al. Reversal of neuromuscular blockade by sugammadex in laparoscopic bariatric surgery: in support of dose reduction. Anaesth Crit Care Pain Med 2006;35:25-9.
11 Mirakhur RK, Jones CJ, Dundee JW. Effects of intravenous administration of glycopyrrolate and atropine in anaesthetized patients. Anaesthesia 1980;35:277-81.
12 Azar I, Pham AN, Karambelkar DJ, et al. The heart rate following edrophonium-atropine and edrophonium-glycopyrrolate mixtures. Anestheology 1983;59:139-41.   DOI