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A comparison of sugammadex and neostigmine for reversal of rocuronium‐induced neuromuscular blockade in children
Author(s) -
Ammar A. S.,
Mahmoud K. M.,
Kasemy Z. A.
Publication year - 2017
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12868
Subject(s) - sugammadex , neostigmine , medicine , rocuronium , pacu , anesthesia , neuromuscular blockade , postoperative nausea and vomiting , nausea , vomiting , adverse effect , intubation
Background Sugammadex is designed to be a reversal agent for steroidal muscle relaxants. The current trial was aimed to compare between sugammadex and neostigmine concerning the recovery time from neuromuscular blockade. We hypothesised that sugammadex might have shorter recovery time than neostigmine. Methods Sixty paediatric patients aged 2–10 years scheduled for lower abdominal surgeries were randomly assigned into two equal groups to receive 4 mg/kg sugammadex (Group S) or 0.35 mg/kg neostigmine and 0.02 mg/kg atropine (Group N) as a reversal agent for rocuronium at the end of surgery. Primary outcome was the recovery time [time from starting of sugammadex or neostigmine till reaching train of four ( TOF ) ratio> 0.9] whereas secondary outcomes included number of patients who needed another dose of sugammadex or neostigmine to reach TOF ratio> 0.9, extubation time (time from stoppage of anaesthetic inhalation until the patient fulfilled criteria for safe extubation, post‐anaesthesia care unit ( PACU ) discharge time and post‐operative adverse effects. Results The mean recovery and extubation times were significantly shorter ( P = 0.002 and 0.005) in Group S compared with Group N (2.5 and 2.0 min vs. 12.6 min and 4.3 min respectively). In the Group N, eight patients needed another reversal dose compared with one patient in Group S ( P = 0.035). PACU discharge time showed no significant difference between both groups. Incidence of nausea, vomiting, tachycardia, and dry mouth were significantly higher in Group N. Conclusion Sugammadex administration in children resulted in faster recovery and extubation times and lower incidence of adverse events compared with neostigmine.