Pediatrik olgularda uygulanan rijit bronkoskopi işleminde anestezi derlemesinde sugammadeks ve neostigminin etkinliğininin karşılaştırılması

Year 2022, , 136 - 141, 30.08.2022

Mehmet Duran , Mehmet Tepe , Mehmet Şirin Mağaç , Öğünç Apaydın , Mevlüt Doğukan , Çiğdem Demirci

https://doi.org/10.30569/adiyamansaglik.997055

Cited By: 2

Abstract

Amaç: Trakeobronşiyal yabancı cisim aspirasyonu nedeniyle rijit bronkoskopi yapılan çocuklarda roküronyumun neden olduğu nöromüsküler blokajın tersine çevrilmesinde kullanılan sugammadeks ve neostigminin etkinliğininin karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Hastanemizde 2013-2018 tarihleri arasında 0-18 yaş grubu çocuklarda, yabancı cisim aspirasyonu şüphesi ile rijit bronkoskopi yapılan 54 hastanın verileri geriye dönük olarak incelendi.
Bulgular: Olguların 30’u erkek, 24’ü kızdı. Nöromüsküler blokajın tersine çevrilmesi amacıyla, 23 olguya atropin- neostigmin ve 31 olguya da sugammadeks uygulanmıştı. 41 olguda komplikasyon saptanmazken 6 olguda bronkospazm, 5 olguda hipoksi, 2 olguda laringospazm saptandı. Derlenme süresi sugammadeks uygulanan olgularda daha kısa tespit edilmiştir (p<0,001).
Sonuç: Pediyatrik rijit bronkoskopi anestezi uygulamasında roküronyumun neden olduğu nöromüsküler blokajın tersine çevrilmesinde, sugammadeks uygulanması sonrası derlenme süresi daha kısadır. 

Keywords

Pediyatrik rijit bronkoskopi, Sugammadeks, Roküronyum, Neostigmin

Supporting Institution

yok

Project Number

yok

Comparison of the effects of sugammadex and neostigmine on recovery of anesthesia in rigid bronchoscopy in pediatric cases

Abstract

Aim: To compare the efficacy of sugammadex and neostigmine, which are used to reverse rocuronium- neuromuscular blockade in children who underwent rigid bronchoscopy due to tracheobronchial foreign body aspiration.
Materials and Methods: The data of 54 patients who underwent rigid bronchoscopy with the suspicion of foreign body aspiration in children aged 0-18 in our hospital between 2013 and 2018 were retrospectively analyzed.
Results: Thirty of the cases were male and 24 were female. Atropine-neostigmine was administered to 23 patients and sugammadex was administered to 31 patients to reverse neuromuscular blockade. While no complications were found in 41 cases, bronchospasm was found in 6 cases, hypoxia in 5 cases, and laryngospasm in 2 cases. Recovery time was shorter in patients who received sugammadex (p<0.001).
Conclusion: Recovery time is shorter after sugammadex administration in reversing rocuronium-induced neuromuscular blockade in pediatric rigid bronchoscopy anesthesia.

Keywords

Pediatric Rigid Bronchoscopy, Sugammadex, Rocuronium, Neostigmine

Project Number

yok

References

• Brkic F, Umihanic S, Altumbabic H, et al. Death as a Consequence of Foreign Body Aspiration in Children. Med Arch. 2018;72(3):220-223. doi:10.5455/medarh.2018.72.220-223
• Liu J, Xiao K, Lv X. Anesthesia and ventilation for removal of airway foreign bodies in 35 infants. Int J Clin Exp Med. 2014;7(12):5852-5856. Published 2014 Dec 15.
• Rangalakshmi S, Dixit N. Anesthetic management in removal of neglected tracheobronchial foreign body. J Anaesthesiol Clin Pharmacol. 2013;29(1):127-128. doi:10.4103/0970-9185.105825
• Farrell PT. Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation. Paediatr Anaesth. 2004;14(1):84-89. doi:10.1046/j.1460-9592.2003.01194.x
• Soodan A, Pawar D, Subramanium R. Anesthesia for removal of inhaled foreign bodies in children. Paediatr Anaesth. 2004;14(11):947-952. doi:10.1111/j.1460-9592.2004.01309.x
• Soysal O, Kuzucu A, Ulutas H. Tracheobronchial foreign body aspiration: a continuing challenge. Otolaryngol Head Neck Surg. 2006;135(2):223-226. doi:10.1016/j.otohns.2005.09.035
• Nicholson WT, Sprung J, Jankowski CJ. Sugammadex: a novel agent for the reversal of neuromuscular blockade. Pharmacotherapy. 2007;27(8):1181-1188. doi:10.1592/phco.27.8.1181
• Bhaskar SB. Emergence from anaesthesia: Have we got it all smoothened out?. Indian J Anaesth. 2013;57(1):1-3. doi:10.4103/0019-5049.108549
• Sinha V, Chhaya V, Barot DS, et al. Foreign body in tracheobronchial tree. Indian J Otolaryngol Head Neck Surg. 2010;62(2):168-170. doi:10.1007/s12070-010-0044-2
• Zhang J, Wang Y, Li B, Zhang W. Remifentail infusion for paediatric bronchoscopic foreign body removal: comparison of sevoflurane with propofol for anaesthesia supplementation for bronchoscope insertion. Anaesth Intensive Care. 2010;38(5):905-910. doi:10.1177/0310057X1003800431
• Liao R, Li JY, Liu GY. Comparison of sevoflurane volatile induction/maintenance anaesthesia and propofol-remifentanil total intravenous anaesthesia for rigid bronchoscopy under spontaneous breathing for tracheal/bronchial foreign body removal in children. Eur J Anaesthesiol. 2010;27(11):930-934. doi:10.1097/EJA.0b013e32833d69ad
• Kendigelen P. The anaesthetic consideration of tracheobronchial foreign body aspiration in children. J Thorac Dis. 2016;8(12):3803-3807. doi:10.21037/jtd.2016.12.69
• Karaaslan E, Yildiz T. Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration. Pak J Med Sci. 2019;35(6):1592-1597. doi:10.12669/pjms.35.6.1225
• Fitzpatrick PC, Guarisco JL. Pediatric airway foreign bodies. J La State Med Soc. 1998;150(4):138-141.
• Hayes AH, Mirakhur RK, Breslin DS, Reid JE, McCourt KC. Postoperative residual block after intermediate-acting neuromuscular blocking drugs. Anaesthesia. 2001;56(4):312-318. doi:10.1046/j.1365-2044.2001.01921.x
• Sorgenfrei IF, Norrild K, Larsen PB, et al. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study. Anesthesiology. 2006;104(4):667-674. doi:10.1097/00000542-200604000-00009
• Bom A, Bradley M, Cameron K, et al. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. Angew Chem Int Ed Engl. 2002;41(2):266-270. doi:10.1002/1521-3773(20020118)41:2<265::aid-anie265>3.0.co;2-q
• 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. doi:10.1016/j.jclinane.2016.06.018
• Ammar AS, Mahmoud KM, Kasemy ZA. A comparison of sugammadex and neostigmine for reversal of rocuronium-induced neuromuscular blockade in children. Acta Anaesthesiol Scand. 2017;61(4):374-380. doi:10.1111/aas.12868
• Li L, Jiang Y, Zhang W. Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery: A Randomized Controlled Study. J Cardiothorac Vasc Anesth. 2021;35(5):1388-1392. doi:10.1053/j.jvca.2020.08.069
• 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(34):e4678. doi:10.1097/MD.0000000000004678
• Mogahed MM, Mohamed RM, Hamed JME. Sugammadex Efficacy for Rapid Reversal of Rocuronium Induced Neuromuscular Blockade in Pediatric Rigid Bronchoscopy Regardless the Depth of Anesthesia. J Anesth Clin Res. 2017, 8.769: 2.
• Korkmaz MO, Sayhan H, Guven M. Does sugammadex decrease the severity of agitation and complications in pediatric patients undergoing adenotonsillectomy?. Saudi Med J. 2019;40(9):907-913. doi:10.15537/smj.2019.9.24485
• Franz AM, Chiem J, Martin LD, Rampersad S, Phillips J, Grigg EB. Case series of 331 cases of sugammadex compared to neostigmine in patients under 2 years of age. Paediatr Anaesth. 2019;29(6):591-596. doi:10.1111/pan.13643