Tags

Type your tag names separated by a space and hit enter

Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study.

Abstract

STUDY OBJECTIVE

To evaluate the influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium after pars plana vitrectomy (PPV) under general anesthesia.

DESIGN

Prospective, double-blind, randomized controlled trial.

SETTING

This study was conducted in a University Teaching Hospital from February to July 2017.

PATIENTS

A total of 84 patients with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo PPV under general anesthesia.

INTERVENTIONS

The patients were randomly assigned to the neostigmine (Group N, n = 44) or sugammadex (Group S, n = 40) groups; 3 ml of study drug was prepared for the patients. For patients in Group N, a solution of neostigmine methylsulfate (1 mg) and glycopyrrolate (0.2 mg) was prepared, while a solution of sugammadex sodium (2 mg/kg) and normal saline was prepared for patients in Group S.

MEASUREMENTS

The primary endpoint was the effect of sugammadex, compared with neostigmine, on the recovery rate in the physiological domain in patients who underwent PPV with general anesthesia. The quality of recovery was assessed using the Postoperative Quality Recovery Scale at 15 min and 40 min after surgery, and on postoperative day 1.

MAIN RESULTS

The recovery rate in the physiological domain was higher in Group S at 15 min after surgery (P = 0.020). Though there were no significant differences in the overall cognitive recovery domain, patients in Group S could recall more numbers in reverse order. However, there were no significant differences between the groups in the other domains of the scale.

CONCLUSIONS

The use of sugammadex may increase the quality of physiological recovery at early postoperative periods, compared with that of neostigmine, following a single bolus dose of rocuronium in patients undergoing PPV with general anesthesia.

TRIAL REGISTRATION

Registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03108989). Registration number: NCT03108989.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.

    ,

    Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.

    ,

    Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.

    ,

    Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.

    ,

    Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Republic of Korea.

    ,

    Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.

    Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea. Electronic address: sjbae@yuhs.ac.

    Source

    Journal of clinical anesthesia 57: 2019 Mar 30 pg 97-102

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    30939422

    Citation

    Kim, Na Young, et al. "Influence of Reversal of Neuromuscular Blockade With Sugammadex or Neostigmine On Postoperative Quality of Recovery Following a Single Bolus Dose of Rocuronium: a Prospective, Randomized, Double-blinded, Controlled Study." Journal of Clinical Anesthesia, vol. 57, 2019, pp. 97-102.
    Kim NY, Koh JC, Lee KY, et al. Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study. J Clin Anesth. 2019;57:97-102.
    Kim, N. Y., Koh, J. C., Lee, K. Y., Kim, S. S., Hong, J. H., Nam, H. J., & Bai, S. J. (2019). Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study. Journal of Clinical Anesthesia, 57, pp. 97-102. doi:10.1016/j.jclinane.2019.02.014.
    Kim NY, et al. Influence of Reversal of Neuromuscular Blockade With Sugammadex or Neostigmine On Postoperative Quality of Recovery Following a Single Bolus Dose of Rocuronium: a Prospective, Randomized, Double-blinded, Controlled Study. J Clin Anesth. 2019 Mar 30;57:97-102. PubMed PMID: 30939422.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study. AU - Kim,Na Young, AU - Koh,Jae Chul, AU - Lee,Ki-Young, AU - Kim,Sung Soo, AU - Hong,Jung Hwa, AU - Nam,Hoon Jae, AU - Bai,Sun-Joon, Y1 - 2019/03/30/ PY - 2018/12/14/received PY - 2019/01/30/revised PY - 2019/02/12/accepted PY - 2019/4/3/pubmed PY - 2019/4/3/medline PY - 2019/4/3/entrez KW - Anesthesia recovery period KW - Neostigmine KW - Neuromuscular blockade KW - Sugammadex SP - 97 EP - 102 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 57 N2 - STUDY OBJECTIVE: To evaluate the influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium after pars plana vitrectomy (PPV) under general anesthesia. DESIGN: Prospective, double-blind, randomized controlled trial. SETTING: This study was conducted in a University Teaching Hospital from February to July 2017. PATIENTS: A total of 84 patients with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo PPV under general anesthesia. INTERVENTIONS: The patients were randomly assigned to the neostigmine (Group N, n = 44) or sugammadex (Group S, n = 40) groups; 3 ml of study drug was prepared for the patients. For patients in Group N, a solution of neostigmine methylsulfate (1 mg) and glycopyrrolate (0.2 mg) was prepared, while a solution of sugammadex sodium (2 mg/kg) and normal saline was prepared for patients in Group S. MEASUREMENTS: The primary endpoint was the effect of sugammadex, compared with neostigmine, on the recovery rate in the physiological domain in patients who underwent PPV with general anesthesia. The quality of recovery was assessed using the Postoperative Quality Recovery Scale at 15 min and 40 min after surgery, and on postoperative day 1. MAIN RESULTS: The recovery rate in the physiological domain was higher in Group S at 15 min after surgery (P = 0.020). Though there were no significant differences in the overall cognitive recovery domain, patients in Group S could recall more numbers in reverse order. However, there were no significant differences between the groups in the other domains of the scale. CONCLUSIONS: The use of sugammadex may increase the quality of physiological recovery at early postoperative periods, compared with that of neostigmine, following a single bolus dose of rocuronium in patients undergoing PPV with general anesthesia. TRIAL REGISTRATION: Registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03108989). Registration number: NCT03108989. SN - 1873-4529 UR - https://www.unboundmedicine.com/medline/citation/30939422/Influence_of_reversal_of_neuromuscular_blockade_with_sugammadex_or_neostigmine_on_postoperative_quality_of_recovery_following_a_single_bolus_dose_of_rocuronium:_A_prospective,_randomized,_double-blinded,_controlled_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S0952-8180(18)31730-6 DB - PRIME DP - Unbound Medicine ER -