1. Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study.
- Author
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Kim NY, Koh JC, Lee KY, Kim SS, Hong JH, Nam HJ, and Bai SJ
- Subjects
- Aged, Anesthesia, General adverse effects, Double-Blind Method, Female, Humans, Male, Middle Aged, Neostigmine adverse effects, Neuromuscular Blockade adverse effects, Neuromuscular Nondepolarizing Agents administration & dosage, Pain, Postoperative etiology, Pain, Postoperative prevention & control, Postoperative Cognitive Complications diagnosis, Postoperative Cognitive Complications etiology, Prospective Studies, Rocuronium administration & dosage, Rocuronium antagonists & inhibitors, Sugammadex adverse effects, Vitrectomy adverse effects, Anesthesia Recovery Period, Anesthesia, General methods, Neostigmine administration & dosage, Neuromuscular Blockade methods, Neuromuscular Nondepolarizing Agents antagonists & inhibitors, Sugammadex administration & dosage
- Abstract
Study Objective: To evaluate the influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium after pars plana vitrectomy (PPV) under general anesthesia., Design: Prospective, double-blind, randomized controlled trial., Setting: This study was conducted in a University Teaching Hospital from February to July 2017., Patients: A total of 84 patients with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo PPV under general anesthesia., Interventions: The patients were randomly assigned to the neostigmine (Group N, n = 44) or sugammadex (Group S, n = 40) groups; 3 ml of study drug was prepared for the patients. For patients in Group N, a solution of neostigmine methylsulfate (1 mg) and glycopyrrolate (0.2 mg) was prepared, while a solution of sugammadex sodium (2 mg/kg) and normal saline was prepared for patients in Group S., Measurements: The primary endpoint was the effect of sugammadex, compared with neostigmine, on the recovery rate in the physiological domain in patients who underwent PPV with general anesthesia. The quality of recovery was assessed using the Postoperative Quality Recovery Scale at 15 min and 40 min after surgery, and on postoperative day 1., Main Results: The recovery rate in the physiological domain was higher in Group S at 15 min after surgery (P = 0.020). Though there were no significant differences in the overall cognitive recovery domain, patients in Group S could recall more numbers in reverse order. However, there were no significant differences between the groups in the other domains of the scale., Conclusions: The use of sugammadex may increase the quality of physiological recovery at early postoperative periods, compared with that of neostigmine, following a single bolus dose of rocuronium in patients undergoing PPV with general anesthesia., Trial Registration: Registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03108989). Registration number: NCT03108989., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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