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Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia.
Br J Anaesth. 2012 Feb; 108(2):236-9.BJ

Abstract

BACKGROUND

Complete and fast recovery of neuromuscular function is very important in morbidly obese patients because of the possible influence of postoperative residual curarization (PORC) on respiratory function in the postoperative period. Recent reports underline incidences of the residual influence of neuromuscular blocking agents.

METHODS

Seventy morbidly obese (BMI >40 kg m(-2)) patients requiring general anaesthesia and receiving rocuronium for muscle relaxation were randomly assigned into two groups: at the end of the anaesthetic procedure, one group received sugammadex 2 mg kg(-1) of corrected body weight (Group SUG) and the other group received neostigmine 0.05 mg kg(-1) of CBW (Group NEO). At the end of surgery and when response reached a train-of-four (TOF) score of 2, patients received the study drugs. The neuromuscular function was recorded and time to achieve 90% of TOF (safe extubation) was measured. Patients were examined directly after arrival to the post-anaesthesia care unit (PACU) by a blinded investigator for the presence of PORC.

RESULTS

Thirty-five patients received sugammadex and 35 neostigmine. Mean dose of rocuronium was 87.9 vs 85.6 mg (P>0.05), mean time to 90% of TOF was 2.7 vs 9.6 min (P<0.05), and TOF at the PACU was 109.8% vs 85.5% (P<0.05) in Groups SUG and NEO, respectively.

CONCLUSIONS

Administration of sugammadex provides fast recovery of neuromuscular function and prevents PORC in the morbidly obese, however neostigmine does not.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Therapy, BarlickiUniversity Hospital, Medical University of Lodz, Poland. tomgaszyn@poczta.onet.plNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22012861

Citation

Gaszynski, T, et al. "Randomized Comparison of Sugammadex and Neostigmine for Reversal of Rocuronium-induced Muscle Relaxation in Morbidly Obese Undergoing General Anaesthesia." British Journal of Anaesthesia, vol. 108, no. 2, 2012, pp. 236-9.
Gaszynski T, Szewczyk T, Gaszynski W. Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia. Br J Anaesth. 2012;108(2):236-9.
Gaszynski, T., Szewczyk, T., & Gaszynski, W. (2012). Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia. British Journal of Anaesthesia, 108(2), 236-9. https://doi.org/10.1093/bja/aer330
Gaszynski T, Szewczyk T, Gaszynski W. Randomized Comparison of Sugammadex and Neostigmine for Reversal of Rocuronium-induced Muscle Relaxation in Morbidly Obese Undergoing General Anaesthesia. Br J Anaesth. 2012;108(2):236-9. PubMed PMID: 22012861.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia. AU - Gaszynski,T, AU - Szewczyk,T, AU - Gaszynski,W, Y1 - 2011/10/19/ PY - 2011/10/21/entrez PY - 2011/10/21/pubmed PY - 2012/3/10/medline SP - 236 EP - 9 JF - British journal of anaesthesia JO - Br J Anaesth VL - 108 IS - 2 N2 - BACKGROUND: Complete and fast recovery of neuromuscular function is very important in morbidly obese patients because of the possible influence of postoperative residual curarization (PORC) on respiratory function in the postoperative period. Recent reports underline incidences of the residual influence of neuromuscular blocking agents. METHODS: Seventy morbidly obese (BMI >40 kg m(-2)) patients requiring general anaesthesia and receiving rocuronium for muscle relaxation were randomly assigned into two groups: at the end of the anaesthetic procedure, one group received sugammadex 2 mg kg(-1) of corrected body weight (Group SUG) and the other group received neostigmine 0.05 mg kg(-1) of CBW (Group NEO). At the end of surgery and when response reached a train-of-four (TOF) score of 2, patients received the study drugs. The neuromuscular function was recorded and time to achieve 90% of TOF (safe extubation) was measured. Patients were examined directly after arrival to the post-anaesthesia care unit (PACU) by a blinded investigator for the presence of PORC. RESULTS: Thirty-five patients received sugammadex and 35 neostigmine. Mean dose of rocuronium was 87.9 vs 85.6 mg (P>0.05), mean time to 90% of TOF was 2.7 vs 9.6 min (P<0.05), and TOF at the PACU was 109.8% vs 85.5% (P<0.05) in Groups SUG and NEO, respectively. CONCLUSIONS: Administration of sugammadex provides fast recovery of neuromuscular function and prevents PORC in the morbidly obese, however neostigmine does not. SN - 1471-6771 UR - https://www.unboundmedicine.com/medline/citation/22012861/Randomized_comparison_of_sugammadex_and_neostigmine_for_reversal_of_rocuronium_induced_muscle_relaxation_in_morbidly_obese_undergoing_general_anaesthesia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0007-0912(17)32479-0 DB - PRIME DP - Unbound Medicine ER -