Nöromusküler Monitorizasyon Rehberliğinin Olmadığı Hastalarda, Sugammadex Ekstübasyon için Güvenilir bir Seçenek Midir? Randomize Klinik Çalışma

Abstract

Objectives: In patients undergoing septorhinoplasty, anesthesia and management of postoperative care may be challenging, especially at extubation, due to nasal packing. Maintaining a patent airway is a critical issue in these patients. In this study, extubation characteristics of sugammadex in the absence of neuromuscular monitorization were evaluated. Materials and Methods: In this randomized, prospective trial, 90 patients who underwent septorhinoplasty were allocated to groups to reversal with either neostigmine or sugammadex, with or without neuromuscular monitorization guidance for extubation. The induction and maintenance were standardized for all groups and groups were differed according to the reversal agent and presence of neuromuscular monitorization. The extubation conditions were recorded. Extubation time and time spent in postanesthesia care unit were also recorded.Adverse events such as throat pain, cough, straining, or laryngospasm were recorded in the operating room and until discharge from the post anesthesia care unit. Nasal bleeding and change of packing were recorded. Results: The mean extubation time (time from the administration of reversal agent to extubation) and post anesthesia care unit stay time [Group 1: 20.5±4.1 minute (min), Group 2: 21.3±7.3 min, Group 3: 12 12.2±2.9 min, Group 4: 12.7±2.5 min] (p=0.001) were significantly shorter in the sugammadex groups than in the neostigmine groups. Number of patients in the sugammadex groups required less mask ventilation compared to the neostigmine groups, regardless of the neuromuscular monitorization. Conclusion: Sugammadex may provide favorable extubation conditions than neostigmine regardless of objective neuromuscular monitorization

Keywords

• Extubation
• Neostigmine
• Sugammadex

References

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