Research Article
BibTex RIS Cite

Sugammadeks uygulamalarımızın retrospektif incelenmesi

Year 2019, Volume: 12 Issue: 2, 202 - 209, 30.08.2019
https://doi.org/10.26559/mersinsbd.462786

Abstract

Amaç:
Sugammadeks; genel anestezi uygulamalarında steroid yapıda kas gevşeticilerin
etkisini farmakolojik olarak ortadan kaldıran ve yan etkileri az görülen bir
ajandır. Ancak maliyeti yüksek olduğu, iki yaş altında kullanımı konusunda
yeterli veri bulunmadığı, diğer ilaç ve besinlerle etkileşimi tam olarak
bilinmediği için kullanımı kısıtlıdır. Bu çalışma ile sugammadeks kullanılan
hastaların çeşitli parametreleri incelenmiş olup, sonuçlarımızı paylaşmayı ve
yeni çalışmalara ışık tutmayı amaçladık. Yöntem:
Retrospektif olan bu çalışmada, dosya taraması yapılarak genel anestezi altında
ameliyata alınan ve sugammadeks kullanılan hastaların cinsiyetleri, branşlara
göre sayıları, yaş aralıkları, sugammadeks kullanım endikasyonları elektronik
ortama aktarılmış, sayılar % dağılım olarak ifade edilmiştir. Kullanılan
sugammadeks dozları miligram/kilogram, anestezi risk değerlerinin ortalaması
rakamsal olarak ifade edilmiştir. Bulgular:
Farklı branşlarda sugammadeks kullanılan 1381 hasta çalışmaya dahil edildi.
Hastaların 506’sı kadın, 875’i erkekti. 
22 hasta 2 yaş ve altı, 65 hasta 3-7 yaş arası, 135 hasta 8-18 yaş
arası, 874 hasta 19-65 yaş arası, 253 hasta 66 yaş ve üzerindeydi. 317 hasta
ASA (American Society of Anesthesiologists, anestezi risk sınıflaması)-I, 636
hasta ASA-II, 300 hasta ASA-III, 128 hasta ASA-IV risk grubunda idi. Ortalama
ASA değeri 2.20 idi. Sugammadeks zor entübasyon (n=55), obesite cerrahisi
(n=110), vertebral cerrahi (n=274), atropin ve neostigmin ile yetersiz
dekürarizasyon (n=30), ameliyat iptali veya hızlı uyandırma gerektiren durum
(n=100), 80 yaş üzeri (n=26), konjental malformasyon (mukopolisakkaridoz tip 3,
vajinal agenezi=Rokitansky Mayer Hauser
Küstner sendromu, doudenal atrezili
down sendromu)
(n=3), neostigmin kullanımının
kontrendike olması (n=783) nedeniyle kullanılmıştı. Ameliyat süreleri en kısa
15 dakika, en uzun 420 dakika idi. Sugammadeks kullanım dozu 2.0-4.0
miligram/kilogram arasındaydı. Hastalarda anaflaksi veya benzeri herhangi bir
yan etkiye rastlanmadı. Sonuç: Bu
çalışmanın sonuçları sugammadeksin; cinsiyet ayırdetmeden, yaş farkı
gözetmeden, ASA risk faktörü düşük veya yüksek, tüm branşların kısa veya uzun
süreli ameliyatlarında 2.0-4.0 mg/kg doz aralığında güvenle kullanılabilecek
bir ilaç olduğunu göstermektedir.

References

  • Referans1. Büyükkoçak Ü. Sinir Kas Bloğunun Antagonize Edilmesi ve Sugammadeks. Türkiye Klinikleri Journal of Anesthesiology Reanimation-Special Topics. 2011;4(2):58-66.
  • Referans2. Tayfun ET. Sugammadex. Kocatepe Tıp Dergisi. 2015;16:273-278.
  • Referans3. Srivastava A, Hunter JM. Reversal of neuromuscular block. British Journal of Anaesthesia. 2009;103(1):115-2.
  • Referans4. Boer HD, Egmond J, Pol F, Bom A, Booij L. Chemical encapsulation of rocuronium by synthetic cyclodextrin derivatives: reversal of neuromuscular block in anaesthetized Rhesus monkeys. British Journal of Anaesthesia. 2006;96(2):201-206.
  • Referans5. Sparr HJ, Vermeyen KM, Beaufort AM, Rietbergen H, Proost JH, Saldien V, Velik-Salchner C, Wierda JM. Early Reversal of Profound Rocuronium-induced Meeting Abstracts by Sugammadex in a Randomized Multicenter Study: Efficacy, Safety, and Pharmacokinetics. Anesthesiology. 2007;106:935-943.
  • Referans6. Bom A, Bradley M, Cameron K, Clark JK, Egmond JV, Feilden H, Mclean EJ, Muir AW, PalinR, Rees DC, Zhang MO. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetichost. Angewandte Chemie International Edition. 2002;4(2):266-70.
  • Referans7. http://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system (son erişim tarihi: 09.09.2018)
  • Referans8. Naguib M. Sugammadex: Another Milestone in Clinical Neuromuscular Pharmacology. International Anesthesia Research Society. 2007;104(3):575-581.
  • Referans9. Karin KB, Magnus W, Bernard V, Jose LT, Henk R, Jose AG. Sugammadex Provides Faster Reversal of Vecuronium-Induced Neuromuscular Blockade Compared with Neostigmine: A Multicenter, Randomized, Controlled Trial. Anesthesia & Analgesia. 2010;110:64-73.
  • Referans10. Saçan Ö, White P, Tufanoğulları B, Klein K. Sugammadex Reversal of Rocuronium-Induced Neuromuscular Blockade: A Comparison with Neostigmine–Glycopyrrolate and Edrophonium–Atropine International Anesthesia Research Society. 2007;104(3):569-574.
  • Referans11. Carron M, Gasparetto M, Vindigni V, Foletto M. Laparoscopic surgery in a morbidly obese, high-risk cardiac patient: the benefits of deep neuromuscular block and sugammadex. British Journal of Anaesthesia. 2014;113:186-187.
  • Referans12. McDonagh DL, Benedict PE, Kovac AL. Efficacy and safety of sugammadex for reversal of rocuroniuminduced blockade in elderly patients. Anesthesiology 2011;114(2):318-29.
  • Referans13. Shenkman Z, Shir Y, Brodsky JB. Peri operative management of the obese patient. British Journal of Anaesthesia 1993;70(3):349-59.
  • Referans14. Staals LM, Snoeck MMJ, Driessen JJ. Multicentre, parallel-group, comparative trial evaluating the efficacy and safety of sugammadex in patients with end-stage renal failure ornormal renal function. Br J Anaesth. 2008;101(4):492-7
  • Referans15. Blobner M, Eriksson L, Scholz J. Reversal of rocuronium-induced neuromuscular blockade with sugammadex compared with neostigmine during sevoflurane anaesthesia: results of a randomised, controlled trial. Eur J Anaesthesiol 2010;27(10):874-81.
  • Referans16. Sarı S. Side effects of sugammadex use in pediatric patients. Klinik ve Deneysel Araştırmalar Dergisi. 2013;4(3):265-268.
  • Referans17. Güleç N, Sarıkaş CM, Yeksan AN, Oba S. Desflurane anestezisinde rokuronyum sonrası sugammadeks ve neostigmin ile dekürarizasyonun karşılaştırılması. Kafkas Tıp Bilimleri Dergisi. 2015;2:48-53.
  • Referans18. Koç F, Turan G, Subaşı D, Ekinci O. Kısa Süreli Cerrahide Sugammadeks ile Neostigminin Karşılaştırılması. Journal of Clinical and Analytical Medicine. 2015;6(1):41-45.
  • Referans19. Ünal DY, Baran İ, Mutlu M. Obstrüktif Uyku Apnesi Ameliyatı Yapılan Hastalarda Sugammadeks ve Neostigmin Kullanımının Solunum Sistemi Komplikasyonları ve Maliyetinin Karşılaştırılması. Journalagent.com. 2015;43(6):387-395.
  • Referans20. Çolak A, Yılmaz E, Kıray B. Pediatrik Vakada Sugammadeks Enjeksiyonunu Takiben Oluşan Hipersensitivite Reaksiyonu. 2018;46(1):66-68.
  • Referans21. Yazıcıoğlu D, Arık E, Ural SG. Neostigmin Anafilaksisine Bağlı Kardiyojenik Pulmoner Ödem. Turkiye Klinikleri J Case Rep. 2015;23(1):8-11.
  • Referans22. Peeters PAM, Heuvel MW, Heumen E, Passier PC, Smeets MW Zwiers A. Safety, tolerability and pharmacokinetics of sugammadex using single high doses (up to 96mg/kg) in healthy adult subjects: a randomized, double-blind, crossover, placebo-controlled, single-centre study. Clin Drug Investig. 2010;30(12):867-874.
  • Referans23. Groudine SB, Soto R, Lien C, Drover D, Roberts K. A Randomized, Dose-Finding, Phase II Study of the Selective Relaxant Binding Drug, Sugammadex, Capable of Safely Reversing Profound Rocuronium-Induced Neuromuscular Block. Anesthetic Pharmacology. 2007;104(3):555-562.
  • Referans24. Sorgenfrei IF, Norrild K, Larsen PB, Stensballe J, Østergaard D, Prins ME, Vogensen JV. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex. Anesthesiology. 2006;104:667-674.

Retrospective Investigation of Sugammadex Applications

Year 2019, Volume: 12 Issue: 2, 202 - 209, 30.08.2019
https://doi.org/10.26559/mersinsbd.462786

Abstract

Objective: Sugammadex;
pharmacological elimination of the effects of steroidal muscle relaxants in
general anesthesia applications and side effects is a rare agent. However, the
cost is high, there is not enough data about the use under the age of two
years, and the interaction with other drugs and nutrients is not known, so its
use is limited. In this study, various parameters of sugammadex patients were
examined and we aimed to share our results and to shed light on new studies. Methods: In this retrospective study,
the gender of the patients who underwent surgery under general anesthesia and
sugammadex were used, their numbers, age ranges, sugammadex usage indications
were transferred to the electronic environment and the numbers were expressed
as % distribution. The mean sugammadex doses were expressed in
milligram/kilogram and the mean anesthesia risk values were quantified. Results: A total of 1381 patients with
sugammadex were included in the study. Of the patients, 506 were female and 875
were male. 22 patients under 2 years and under, 65 patients between 3 and 7
years of age, 135 patients aged 8-18 years, 874 patients between 19-65 years of
age, 253 patients over 65 years and older. There were 317 patients with ASA-I,
636 patients with ASA-II, 300 patients with ASA-III and 128 patients with
ASA-IV. The mean ASA value was 2.20. Sugammadex difficult intubation (n = 55),
obesity surgery (n = 110), vertebral surgery (n = 274), inadequate
decurarization with atropine and neostigmine (n = 30), operation cancellation
or rapid awakening (n = 100), Over 80 years old (n = 26), congenital
malformation (mucopolysaccharidosis type 3, vaginal agenesis = Rokitansky Mayer
Hauser Küstner syndrome, down syndrome of doudenal atresia) (n = 3),
contraindication of neostigmine use (n = 783) was used. The operation time was
15 minutes at the shortest and 420 minutes at the longest. Sugammadex
administration dose was between 2.0-4.0 miligram/kilogram. No anaphylaxis or
similar side effects were observed in the patients. Conclusion: The results of this study included sugammadex; without
gender discrimination, age difference, low or high ASA risk, short or long-term
surgery of all branches at a dose of 2-4 mg/kg dose can be used safely shows a
drug.

References

  • Referans1. Büyükkoçak Ü. Sinir Kas Bloğunun Antagonize Edilmesi ve Sugammadeks. Türkiye Klinikleri Journal of Anesthesiology Reanimation-Special Topics. 2011;4(2):58-66.
  • Referans2. Tayfun ET. Sugammadex. Kocatepe Tıp Dergisi. 2015;16:273-278.
  • Referans3. Srivastava A, Hunter JM. Reversal of neuromuscular block. British Journal of Anaesthesia. 2009;103(1):115-2.
  • Referans4. Boer HD, Egmond J, Pol F, Bom A, Booij L. Chemical encapsulation of rocuronium by synthetic cyclodextrin derivatives: reversal of neuromuscular block in anaesthetized Rhesus monkeys. British Journal of Anaesthesia. 2006;96(2):201-206.
  • Referans5. Sparr HJ, Vermeyen KM, Beaufort AM, Rietbergen H, Proost JH, Saldien V, Velik-Salchner C, Wierda JM. Early Reversal of Profound Rocuronium-induced Meeting Abstracts by Sugammadex in a Randomized Multicenter Study: Efficacy, Safety, and Pharmacokinetics. Anesthesiology. 2007;106:935-943.
  • Referans6. Bom A, Bradley M, Cameron K, Clark JK, Egmond JV, Feilden H, Mclean EJ, Muir AW, PalinR, Rees DC, Zhang MO. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetichost. Angewandte Chemie International Edition. 2002;4(2):266-70.
  • Referans7. http://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system (son erişim tarihi: 09.09.2018)
  • Referans8. Naguib M. Sugammadex: Another Milestone in Clinical Neuromuscular Pharmacology. International Anesthesia Research Society. 2007;104(3):575-581.
  • Referans9. Karin KB, Magnus W, Bernard V, Jose LT, Henk R, Jose AG. Sugammadex Provides Faster Reversal of Vecuronium-Induced Neuromuscular Blockade Compared with Neostigmine: A Multicenter, Randomized, Controlled Trial. Anesthesia & Analgesia. 2010;110:64-73.
  • Referans10. Saçan Ö, White P, Tufanoğulları B, Klein K. Sugammadex Reversal of Rocuronium-Induced Neuromuscular Blockade: A Comparison with Neostigmine–Glycopyrrolate and Edrophonium–Atropine International Anesthesia Research Society. 2007;104(3):569-574.
  • Referans11. Carron M, Gasparetto M, Vindigni V, Foletto M. Laparoscopic surgery in a morbidly obese, high-risk cardiac patient: the benefits of deep neuromuscular block and sugammadex. British Journal of Anaesthesia. 2014;113:186-187.
  • Referans12. McDonagh DL, Benedict PE, Kovac AL. Efficacy and safety of sugammadex for reversal of rocuroniuminduced blockade in elderly patients. Anesthesiology 2011;114(2):318-29.
  • Referans13. Shenkman Z, Shir Y, Brodsky JB. Peri operative management of the obese patient. British Journal of Anaesthesia 1993;70(3):349-59.
  • Referans14. Staals LM, Snoeck MMJ, Driessen JJ. Multicentre, parallel-group, comparative trial evaluating the efficacy and safety of sugammadex in patients with end-stage renal failure ornormal renal function. Br J Anaesth. 2008;101(4):492-7
  • Referans15. Blobner M, Eriksson L, Scholz J. Reversal of rocuronium-induced neuromuscular blockade with sugammadex compared with neostigmine during sevoflurane anaesthesia: results of a randomised, controlled trial. Eur J Anaesthesiol 2010;27(10):874-81.
  • Referans16. Sarı S. Side effects of sugammadex use in pediatric patients. Klinik ve Deneysel Araştırmalar Dergisi. 2013;4(3):265-268.
  • Referans17. Güleç N, Sarıkaş CM, Yeksan AN, Oba S. Desflurane anestezisinde rokuronyum sonrası sugammadeks ve neostigmin ile dekürarizasyonun karşılaştırılması. Kafkas Tıp Bilimleri Dergisi. 2015;2:48-53.
  • Referans18. Koç F, Turan G, Subaşı D, Ekinci O. Kısa Süreli Cerrahide Sugammadeks ile Neostigminin Karşılaştırılması. Journal of Clinical and Analytical Medicine. 2015;6(1):41-45.
  • Referans19. Ünal DY, Baran İ, Mutlu M. Obstrüktif Uyku Apnesi Ameliyatı Yapılan Hastalarda Sugammadeks ve Neostigmin Kullanımının Solunum Sistemi Komplikasyonları ve Maliyetinin Karşılaştırılması. Journalagent.com. 2015;43(6):387-395.
  • Referans20. Çolak A, Yılmaz E, Kıray B. Pediatrik Vakada Sugammadeks Enjeksiyonunu Takiben Oluşan Hipersensitivite Reaksiyonu. 2018;46(1):66-68.
  • Referans21. Yazıcıoğlu D, Arık E, Ural SG. Neostigmin Anafilaksisine Bağlı Kardiyojenik Pulmoner Ödem. Turkiye Klinikleri J Case Rep. 2015;23(1):8-11.
  • Referans22. Peeters PAM, Heuvel MW, Heumen E, Passier PC, Smeets MW Zwiers A. Safety, tolerability and pharmacokinetics of sugammadex using single high doses (up to 96mg/kg) in healthy adult subjects: a randomized, double-blind, crossover, placebo-controlled, single-centre study. Clin Drug Investig. 2010;30(12):867-874.
  • Referans23. Groudine SB, Soto R, Lien C, Drover D, Roberts K. A Randomized, Dose-Finding, Phase II Study of the Selective Relaxant Binding Drug, Sugammadex, Capable of Safely Reversing Profound Rocuronium-Induced Neuromuscular Block. Anesthetic Pharmacology. 2007;104(3):555-562.
  • Referans24. Sorgenfrei IF, Norrild K, Larsen PB, Stensballe J, Østergaard D, Prins ME, Vogensen JV. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex. Anesthesiology. 2006;104:667-674.
There are 24 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Havva Kubat 0000-0003-0958-9045

Sibel Tetiker This is me 0000-0001-7686-7872

Müge Çelik This is me 0000-0001-7527-6309

Publication Date August 30, 2019
Submission Date September 22, 2018
Acceptance Date November 5, 2018
Published in Issue Year 2019 Volume: 12 Issue: 2

Cite

APA Kubat, H., Tetiker, S., & Çelik, M. (2019). Sugammadeks uygulamalarımızın retrospektif incelenmesi. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 12(2), 202-209. https://doi.org/10.26559/mersinsbd.462786
AMA Kubat H, Tetiker S, Çelik M. Sugammadeks uygulamalarımızın retrospektif incelenmesi. Mersin Univ Saglık Bilim derg. August 2019;12(2):202-209. doi:10.26559/mersinsbd.462786
Chicago Kubat, Havva, Sibel Tetiker, and Müge Çelik. “Sugammadeks uygulamalarımızın Retrospektif Incelenmesi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 12, no. 2 (August 2019): 202-9. https://doi.org/10.26559/mersinsbd.462786.
EndNote Kubat H, Tetiker S, Çelik M (August 1, 2019) Sugammadeks uygulamalarımızın retrospektif incelenmesi. Mersin Üniversitesi Sağlık Bilimleri Dergisi 12 2 202–209.
IEEE H. Kubat, S. Tetiker, and M. Çelik, “Sugammadeks uygulamalarımızın retrospektif incelenmesi”, Mersin Univ Saglık Bilim derg, vol. 12, no. 2, pp. 202–209, 2019, doi: 10.26559/mersinsbd.462786.
ISNAD Kubat, Havva et al. “Sugammadeks uygulamalarımızın Retrospektif Incelenmesi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 12/2 (August 2019), 202-209. https://doi.org/10.26559/mersinsbd.462786.
JAMA Kubat H, Tetiker S, Çelik M. Sugammadeks uygulamalarımızın retrospektif incelenmesi. Mersin Univ Saglık Bilim derg. 2019;12:202–209.
MLA Kubat, Havva et al. “Sugammadeks uygulamalarımızın Retrospektif Incelenmesi”. Mersin Üniversitesi Sağlık Bilimleri Dergisi, vol. 12, no. 2, 2019, pp. 202-9, doi:10.26559/mersinsbd.462786.
Vancouver Kubat H, Tetiker S, Çelik M. Sugammadeks uygulamalarımızın retrospektif incelenmesi. Mersin Univ Saglık Bilim derg. 2019;12(2):202-9.

MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.

Publishing in three issues per year (April - August - December), it is a multisectoral refereed scientific journal. In addition to research articles, scientific articles such as reviews, case reports and letters to the editor are published in the journal. Our journal, which has been published via e-mail since its inception, has been published both online and in print. Following the Participation Agreement signed with TÜBİTAK-ULAKBİM Dergi Park in April 2015, it has started to accept and evaluate online publications.

Mersin University Journal of Health Sciences have been indexed by Turkey Citation Index since November 16, 2011.

Mersin University Journal of Health Sciences have been indexed by ULAKBIM Medical Database from the first issue of 2016.

Mersin University Journal of Health Sciences have been indexed by DOAJ since October 02, 2019.

Article Publishing Charge Policy: Our journal has adopted an open access policy and there is no fee for article application, evaluation, and publication in our journal. All the articles published in our journal can be accessed from the Archive free of charge.

154561545815459

Creative Commons Lisansı
This work is licensed with Attribution-NonCommercial 4.0 International.