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

Year 2021, Volume: 74 Issue: 2, 233 - 238, 31.08.2021

Çiğdem Yıldırım Güçlü , Zekeriyya Alanoğlu Başak Ceyda Meço , Menekşe Özçelik , Sanem Çakar , Barış Adaklı Neslihan Alkış

https://doi.org/10.4274/atfm.galenos.2020.50251

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

Ethical Statement

This study was approved by the Ankara University’s Institutional Ethical Board

Supporting Institution

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Project Number

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Thanks

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