Cardiac effects of Sugammadex and Rocuronium combination in rats: experimental study

Year 2022, Volume: 4 Issue: 3, 244 - 248, 26.07.2022

Mevlüt Doğukan , Nezir Yılmaz , Ebru Annaç , Zümrüt Doğan , Fatih Üçkardeş , Öznur Uludag

https://doi.org/10.38053/acmj.1088069

Abstract

Aim: In this experimental study, it was aimed to examine the effects of rocuronium and sugammadex complex on cardiac muscle cells in rats histopathologically and biochemically.
Matherial and Method: 32 adult Sprague-Dawley male rats were divided into four groups with 8 in each group. Group 1 consisted of animals that did not undergo surgical treatment. Group 2 received a volume equivalent to 16 mg/kg sugammadex with 0.9% intravenous saline. Group 3 received 16 mg/kg of intravenous sugammadex. Group 4, 1 mg/kg intravenous rocuronium and 16 mg/kg intravenous sugammadex were administered to rats. After the procedure completed GSH and MDA level evaluated biochemically; and heart tissue evaluated histopathologically.
Results: In group 4, connective tissue edema between muscle fibers was observed to be significantly increased, vessel dilatation and hemorrhagic areas were observed. Groups 3 and 4 were found to cause an increase in GSH level when compared to Groups 1 and 2, and a decrease in MDA level in these two groups compared to the others.
Conclusion: Although sugammadex and sugammadex-rocuronıum complex cause biochemical and histopathological effect on the heart tissue, there were no irreversible histopathologic changes and no significant biochemical difference found in this study.

Keywords

Sugammadex, rocuronium, cardiac muscle, histopathology, rat

References

• Fisher DM. Clinical pharmacology of neuromuscular blocking agents. Am J Health Syst Pharm 1999; 56: 4–9.
• de Boer HD, van Egmond J, van de Pol F, Bom A, Booij LHDJ. Chemical encapsulation of rocuronium by synthetic cyclodextrin derivatives: Reversal of neuromuscular block in anaesthetized Rhesus monkeys. Br J Anaesth 2006; 96: 201-6.
• Bom A, Bradley M, Cameron K, et al. A novel concept of reversing neuromuscular block: chemi-cal encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. Angew Chem Int Ed Engl 2002; 41: 266-70.
• Carron M, Zarantonello F, Tellaroli P, Ori C. Efficacy and safety of sugammadex compared to neostigmine for reversal of neuromuscular blockade: a meta-analysis of randomized controlled trials. J Clin Anesth 2016; 35: 1-12.
• Hristovska AM, Duch P, Allingstrup M, Afshari A. The comparative efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. A Cochrane systematic review with meta-analysis and trial sequential analysis. Anaesthesia 2018; 73: 631-41.
• Abad-Gurumeta A, Ripollés-Melchor J, Casans-Francés R, et al.A systematic review of sugammadex vs neostigmine for reversal of neuromuscular blockade. Anaesthesia 2015; 70: 1441-52.
• Won YJ, Lim BG, Lee DK, Kim H, Kong MH, Lee IO. Sugammadex for reversal of rocuronium-induced neuromuscular blockade in pediatric patients: a systematic review and meta-analysis. Medicine (Baltimore) 2016; 95: e4678.
• Lee W. The potential risks of sugammadex. Anesth Pain Med 2019; 14: 117-22.
• Uludağ Ö. Effect of sugammadex and rocuronium combination on cranial neurotoxicity in rats: Experimental study. KafkasUniv Vet Fak Derg 2019; 25: 793-9.
• Miller MA, Zachary JF. Mechanisms and morphology of cellular injury, adaptation, and death. In: Pathologic Basis of Veterinary Disease. Elsevier; 2017. p. 2-43.e19.
• Uchiyama M, Mihara M. Determination of malonaldehyde precursor in tissue by TBA test. AnalBiochem1978; 86: 271-8.
• Elman GL. Tissue sulphydryl groups. Arch Biochem Biophys 1959; 82: 70-7.
• Cammu G, De Kam PJ, Demeyer I, et al. Safety and tolerability of single intravenous doses of sugammadex administered simultaneously with rocuronium or vecuronium in healthy volunteers. Br J Anaest 2008; 100: 373–9.
• De Boer HD, Driessen JJ, Marcus MA, Kerkkamp H, Heeringa M, Klimek M. Reversal of rocuronium-induced (1.2 mg/kg) profound neuromuscular block by sugammadex: A multi center, dose-finding and safety study. Anesthesiology 2007; 107: 239–44.
• Osaka Y, Shimada N, Satou M, et al. A case of atrioventricular block (Wenckebach type) induced by sugammadex. J Anesth 2012; 26: 627–8.
• Kokki M, Ali M, Turunen M, Kokki H. Suspected unexpected adverse effect of sugammadex: Hypotension. Eur J Clin Pharmacol 2012; 68: 899–900.
• Bhavani SS. Severe bradycardia and asystole after sugammadex. Br J Anesth 2018; 121: 95–6.
• Tsur A, Kalansky A. Hypersensitivity associated with sugammadex administration: a systematic review. Anaesthesia 2014; 69: 1251–7.
• Dahl V, Pendeville PE, Hollmann MW, Heier T, Abels EA, Blobner M. Safety and efficacy of sugammadex for the reversal of rocuronium-induced neuromuscular blockade in cardiac patients undergoing noncardiac surgery. Eur J Anaesthesiol 2009; 26: 874-84.
• de Kam PJ, van Kuijk J, Prohn M, Thomsen T, Peeters P. Effects of sugammadex doses up to 32 mg/kg alone or in combination with rocuronium or vecuronium on QTc prolongation: a thorough QTc study. Clin Drug Investig 2010; 30: 599–611.
• Bostan H, Kalkan Y, Tomak Y, et al. Reversal of rocuronium-induced neuromuscular block with sugammadex and resulting histopathological effects in rat kidneys. Ren Fail 2011; 33: 1019-24.
• Kalkan Y, Bostan H, Tumkaya L, et al.The effect of rocuronium, sugammadex, and their combination on cardiac muscle and diaphragmatic skeletal muscle cells. J Anesth 2012; 26: 870-7.
• Tercan M, Yılmaz İnal F, Seneldir H, Kocoglu H. Nephroprotective efficacy of sugammadex in ischemia-reperfusion injury: an experimental study in a rat model. Cureus. 2021; 13: e15726.
• Ozbilgin S, Yılmaz O, Ergur BU, et al. Effectiveness of sugammadex for cerebral ischemia/reperfusion injury. Kaohsiung J Med Sci 2016; 32: 292-301.