Reversal of Deep Effect of Rocuronium by Sugammadex or Neostigmine after Abdominal Laparoscopic Surgery: A Single Center Experience in Vietnam

  • Le Van Dong Department of Anesthesia,Cho Ray Hospital, Vietnam; 2Department of Cardiothoracic surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
  • Nguyen Truong Giang Department of Cardiothoracic surgery, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
  • Nguyen Manh Cuong Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
  • Ngo Van Dinh Department of Anesthesia and Pain Medicine, 108 Military Central Hospital, Hanoi, Vietnam
  • Vu The Anh Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
  • Mai Duc Hanh Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
  • Dao Thi Khanh Department of Pharmacy, Military Hospital 103, Vietnam Military Medical University, Vietnam
  • Luu Quang Thuy Center of Anesthesia and Surgical Intensive Care, Viet Duc University Hospital, Vietnam
  • Le Thanh Son Department of Hepato-Biliary-Pancreatic Surgery, Vice Director of the Abdominal Surgery Center, Military Hospital 103, Vietnam Military Medical University, Vietnam
  • Nguyen Dang Thu Department of Anesthesia and Pain Medicine, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam
  • Nguyen Trung Kien Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Vietnam
Keywords: Deep neuromuscular blockade, Abdominal laparoscopic surgery, Sugammadex

Abstract

BACKGROUND: Using sugammadex allows to quickly reverse deep neuromuscular blockade with rocuronium in laparoscopic surgery, which results in great benefits during and after surgery by minimizing the problem of postoperative residual curarization.

AIM: The aims of this study are comparing the efficacy of reversing neuromuscular blockade between sugammadex and neostigmine and evaluating its unwanted effects after laparoscopic abdominal surgery.

METHODS: Subject of this prospective clinical comparative trial was patients who underwent abdominal laparoscopic surgery at 103 Military Hospital from October 2017 to October 2018. Eighty-four patients suffering from abdominal laparoscopic surgery under deep neuromuscular blockade were enrolled and divided randomly into two groups with 42 patients in each: Group N used neostigmine for neuromuscular blockade reversal and Group S applied sugammadex. At the end of surgery, neuromuscular blockade was reversed with either sugammadex or neostigmine.

RESULTS: The reversal time to achieve train-of-four ratio >0.9 in the sugammadex group was 2.42 ± 0.58 min, which was shorter than in the neostigmine group (11.83 ± 2.19 min) (p < 0.05). The time until extubation in the sugammadex group was 3.69 ± 0.67 min, which was shorter than in the neostigmine group 11.90 ± 2.22 min (p < 0.05). Reversal with sugammadex resulted in statistical significance of less sputum production (0% vs. 11.9%), dry mouth (0% vs. 28.57%), headache (2.38% vs. 7.14%), and nausea (4.76% vs. 14.28%) compared with neostigmine. However, 26.19% of patients in the neostigmine group presented bradycardia, whereas the concurrent administration of atropine in the neostigmine group resulted in increased heart rate.

CONCLUSION: Sugammadex reversed neuromuscular blockade more rapidly and effectively than neostigmine in abdominal laparoscopic surgeries. The unwanted effects of sugammadex group were fewer than neostigmine group.

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Published
2020-04-20
How to Cite
1.
Dong LV, Giang NT, Cuong NM, Dinh NV, Anh VT, Hanh MD, Khanh DT, Thuy LQ, Son LT, Thu ND, Kien NT. Reversal of Deep Effect of Rocuronium by Sugammadex or Neostigmine after Abdominal Laparoscopic Surgery: A Single Center Experience in Vietnam. Open Access Maced J Med Sci [Internet]. 2020Apr.20 [cited 2020Oct.31];8(B):295-00. Available from: https://www.id-press.eu/mjms/article/view/4236