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Half-dose sugammadex with neostigmine versus full-dose sugammadex for reversal of rocuronium in laparoscopic bariatric surgery.
- Source :
- Ain Shams Journal of Anesthesiology; 7/1/2020, Vol. 12 Issue 1, p1-9, 9p
- Publication Year :
- 2020
-
Abstract
- Background: Sugammadex reverses rocuronium more effective than neostigmine during deeper neuromuscular blockade levels. Relying upon the high cost of sugammadex we hypothesized that combined neostigmine with half-dose sugammadex (1.2 mg/kg) would be as effective as the full dose (2.4 mg/kg IBW) in reversing rocuronium-induced deep neuromuscular block in obese patients. A multimodal approach would be an effective cost saving strategy, while preserving the advantages of this novel agent. Patient and methods: A prospective randomized study done on 50 morbid obese patients undergoing elective laparoscopic sleeve gastrectomy operation. Patients were allocated into two groups each of 25. Group NS received sugammadex 1.2 mg/kg and neostigmine 50 μg/kg with atropine 20 μg/kg. Group S received sugammadex 2.4 mg/kg and 10 mL of normal saline. Primary outcome: Interval between administration of reversal and reaching TOF of 90%. Secondary outcomes: Total dose of rocuronium (mg), duration between last dose rocuronium and reverse, number of patients reached TOF of 90% within 5 min, duration between IV reversal and extubation, and the number of patients with residual neuromuscular blockade. Results: Number of patients who reached TOF 90% within 5 min, the interval between reversal and 90% TOF, the interval between reversal and extubation were comparable between the study groups. Conclusion: As regards neuromuscular blocker reversal in obese patients, the neostigmine 50 μg/kg plus sugammadex half dose (1.2 mg/kg) is as effective as full-dose sugammadex (2.4 mg/kg) alone. Trial registration: Institutional Research Board: (IRB code number): MS/17.12.195 on 16 January 2018. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 16877934
- Volume :
- 12
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Ain Shams Journal of Anesthesiology
- Publication Type :
- Academic Journal
- Accession number :
- 144339872
- Full Text :
- https://doi.org/10.1186/s42077-020-00067-w