Research Article
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Year 2023, Volume: 6 Issue: 4, 720 - 724, 30.07.2023
https://doi.org/10.32322/jhsm.1274418

Abstract

Supporting Institution

yok

References

  • Bom A, Bradley M, Cameron K. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetichost. Angew Chem Int Ed Engl. 2002;4(2):266-270.
  • Kopman AF. Neuromuscular monitoring: Old issues, new controversies. J Crit Care. 2009;24(1):11–20.
  • Fink H, Hollmann MW. Myths and facts in neuromuscular pharmacology. New developments in reversing neuromuscular blockade. Minerva Anestesiol. 2012;78(4):473–482.
  • Schaller SJ, Fink H. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review. Core Evid. 2013;8:57–67.
  • Schaller S, Fink H. A randomized controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparsoscopic surgery. Anaesthesia. 2012;67(9):991–998.
  • Lee CH, Peng MJ, Wu CL. Dexamethasone to prevent postextubation airway obstruction in adults: a prospective, randomized, double-blind, placebo-controlled study. Crit Care. 2007;11(4):R72. doi:10.1186/cc5957
  • Lee MJ, Lee KC, Kim HY, Lee WS, Seo WJ, Lee C. Comparison of ramosetron plus dexamethasone with ramosetron alone on postoperative nausea, vomiting, shivering and pain after thyroid surgery. Korean J Pain. 2015;28(1):39-44. doi:10.3344/kjp.2015.28.1.39
  • Henzi I, Walder B, Tramèr MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg. 2000;90(1):186-194. doi:10.1097/00000539-200001000-00038
  • De Oliveira GS Jr, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011;115(3):575-588. doi:10.1097/ALN.0b013e31822a24c2
  • Rajan S, Menedal A, Pereira C, et al. It`s Not about the destination, it`s about the journey- plotting 50 years of changing clinical trends in plastic surgery in a public sector teaching hospital. Indian J Plast Surg. 2021;54(3):302-307
  • Kara CO, Gokalan I. Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty. Plast Reconstr Surg. 1999;104(7):2213-2218.
  • Rezonja K, Sostaric M, Vidmar G, Mars T. Dexamethasone produces dose-dependent inhibition of sugammadex reversal in in vitro innervated primary human muscle cells. Anesth Analg. 2014;118(4):755–763.
  • Buonanno P, Laiola A, Palumbo C, et al. Dexamethasone dose not inhibit sugammadex reversal after rocuronium-induced neuromuscular block. Anesth Analg. 2006;122(6):1826–1830.
  • Gulec E, Biricik E, Turktan M, Hatipoglu Z, Unlugenc H. The effect of intravenous dexamethasone on sugammadex reversal time in children undergoing adenotonsillectomy. Anesth Analg. 2016;122(4):1147–1152.
  • Batistaki C, Pandazi A, Kyttari A, Kaminiotis E, Kostopanagiotou G. Is there an interaction between dexamethasone and sugammadex in real clinical conditions? A randomized controlled trial in patients undergoing laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2019;35(2):215-219. doi:10.4103/joacp.JOACP_42_17
  • Naguib M, Kopman AF, Ensor JE. Neuromuscular monitoring and postoperative residual curarization: a metaanalysis. Br J Anaesth. 2007;98(3):302–16.
  • Zwiers A, van den Heuvel M, Smeets J, Rutherford S. Assessment of the potential for displacement interactions with sugammadex: a pharmacokinetic‑pharmacodynamic modelling approach. Clin Drug Investig. 2011;31(2):101‑111
  • Zhang MQ. Drug specific cyclodextrins: the future of neuromuscular blocking reversal? Drug Future. 2003;38:347–354.
  • Batistaki C, Pandazi A, Kyttari A, Kaminiotis E, Kostopanagiotou G. Is there an interaction between dexamethasone and sugammadex in real clinical conditions? A randomized controlled trial in patients undergoing laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2019;35(2):215-219. doi:10.4103/joacp.JOACP_42_17
  • Soltész S, Fraisl P, Noé KG, et al. Dexamethasone decreases the duration of rocuronium‑induced neuromuscular block: A randomised controlled study. Eur J Anaesthesiol. 2014;31(8):417‑422.

The interaction of dexamethasone with sugammadex and rocuronium during general anesthesia in rhinoplasty surgeries

Year 2023, Volume: 6 Issue: 4, 720 - 724, 30.07.2023
https://doi.org/10.32322/jhsm.1274418

Abstract

Aims: Sugammadex is a cyclodextrin specifically designed to reverse the action of rocuronium through encapsulation. Theoretically, it is possible that sugammadex can encapsulate cortisone. There have been conflicting results regarding clinical dexamethasone-sugammadex interactions in patients under general anesthesia. The primary outcome of the present study is to investigate any possible alteration in the efficacy of sugammadex as a reversal of rocuronium due to dexamethasone injection in rhinoplasty surgery. The secondary outcome is evaluation of clinical observation sugammadex in these groups of patients.
Methods: Adult patients with the American Society of Anesthesiology (ASA) II risk class undergoing rhinoplasty were included. All patients received standard general anesthesia with neuromuscular blockade using rocuronium. Patients were allocated to either the dexamethasone group or control group. The anesthesiologist measured the time interval between sugammadex injection and the recording of the 90% train of four. Additionally, the duration required for extubation after sugammadex injection was recorded. Finally, the signs of residual respiratory insufficiency and muscle weakness were checked in the post-anesthesia care unit until the 2nd-hour post-surgery.
Results: Sixty-one patients were enrolled in the study. The dexamethasone group included 30, and the control group included 31 patients. The comparison of demographic and surgical characteristics of these two groups showed no statistical difference. The duration required for extubation was higher in dexmethasone group compared to control group (p=0.001). The total rocuronium administration dose was higher in dexmethasone group (p=0.01). The time required for the recovery of the head, upper, and lower extremity lifting was longer in the dexamethasone group (p=0.001, 0.003, and 0.047, respectively).
Conclusion: The present study demonstrated an interaction between sugammadex and dexamethasone, which affected the reversal of neuromuscular blockade during rhinoplasty surgeries.

References

  • Bom A, Bradley M, Cameron K. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetichost. Angew Chem Int Ed Engl. 2002;4(2):266-270.
  • Kopman AF. Neuromuscular monitoring: Old issues, new controversies. J Crit Care. 2009;24(1):11–20.
  • Fink H, Hollmann MW. Myths and facts in neuromuscular pharmacology. New developments in reversing neuromuscular blockade. Minerva Anestesiol. 2012;78(4):473–482.
  • Schaller SJ, Fink H. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review. Core Evid. 2013;8:57–67.
  • Schaller S, Fink H. A randomized controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparsoscopic surgery. Anaesthesia. 2012;67(9):991–998.
  • Lee CH, Peng MJ, Wu CL. Dexamethasone to prevent postextubation airway obstruction in adults: a prospective, randomized, double-blind, placebo-controlled study. Crit Care. 2007;11(4):R72. doi:10.1186/cc5957
  • Lee MJ, Lee KC, Kim HY, Lee WS, Seo WJ, Lee C. Comparison of ramosetron plus dexamethasone with ramosetron alone on postoperative nausea, vomiting, shivering and pain after thyroid surgery. Korean J Pain. 2015;28(1):39-44. doi:10.3344/kjp.2015.28.1.39
  • Henzi I, Walder B, Tramèr MR. Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review. Anesth Analg. 2000;90(1):186-194. doi:10.1097/00000539-200001000-00038
  • De Oliveira GS Jr, Almeida MD, Benzon HT, McCarthy RJ. Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011;115(3):575-588. doi:10.1097/ALN.0b013e31822a24c2
  • Rajan S, Menedal A, Pereira C, et al. It`s Not about the destination, it`s about the journey- plotting 50 years of changing clinical trends in plastic surgery in a public sector teaching hospital. Indian J Plast Surg. 2021;54(3):302-307
  • Kara CO, Gokalan I. Effects of single-dose steroid usage on edema, ecchymosis, and intraoperative bleeding in rhinoplasty. Plast Reconstr Surg. 1999;104(7):2213-2218.
  • Rezonja K, Sostaric M, Vidmar G, Mars T. Dexamethasone produces dose-dependent inhibition of sugammadex reversal in in vitro innervated primary human muscle cells. Anesth Analg. 2014;118(4):755–763.
  • Buonanno P, Laiola A, Palumbo C, et al. Dexamethasone dose not inhibit sugammadex reversal after rocuronium-induced neuromuscular block. Anesth Analg. 2006;122(6):1826–1830.
  • Gulec E, Biricik E, Turktan M, Hatipoglu Z, Unlugenc H. The effect of intravenous dexamethasone on sugammadex reversal time in children undergoing adenotonsillectomy. Anesth Analg. 2016;122(4):1147–1152.
  • Batistaki C, Pandazi A, Kyttari A, Kaminiotis E, Kostopanagiotou G. Is there an interaction between dexamethasone and sugammadex in real clinical conditions? A randomized controlled trial in patients undergoing laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2019;35(2):215-219. doi:10.4103/joacp.JOACP_42_17
  • Naguib M, Kopman AF, Ensor JE. Neuromuscular monitoring and postoperative residual curarization: a metaanalysis. Br J Anaesth. 2007;98(3):302–16.
  • Zwiers A, van den Heuvel M, Smeets J, Rutherford S. Assessment of the potential for displacement interactions with sugammadex: a pharmacokinetic‑pharmacodynamic modelling approach. Clin Drug Investig. 2011;31(2):101‑111
  • Zhang MQ. Drug specific cyclodextrins: the future of neuromuscular blocking reversal? Drug Future. 2003;38:347–354.
  • Batistaki C, Pandazi A, Kyttari A, Kaminiotis E, Kostopanagiotou G. Is there an interaction between dexamethasone and sugammadex in real clinical conditions? A randomized controlled trial in patients undergoing laparoscopic cholecystectomy. J Anaesthesiol Clin Pharmacol. 2019;35(2):215-219. doi:10.4103/joacp.JOACP_42_17
  • Soltész S, Fraisl P, Noé KG, et al. Dexamethasone decreases the duration of rocuronium‑induced neuromuscular block: A randomised controlled study. Eur J Anaesthesiol. 2014;31(8):417‑422.
There are 20 citations in total.

Details

Primary Language English
Subjects Anaesthesiology, Health Care Administration
Journal Section Original Article
Authors

Taylan Şahin 0000-0002-9888-6625

Eryigit Eren 0000-0001-6705-4095

Early Pub Date July 28, 2023
Publication Date July 30, 2023
Published in Issue Year 2023 Volume: 6 Issue: 4

Cite

AMA Şahin T, Eren E. The interaction of dexamethasone with sugammadex and rocuronium during general anesthesia in rhinoplasty surgeries. J Health Sci Med / JHSM. July 2023;6(4):720-724. doi:10.32322/jhsm.1274418

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