Svalová relaxancia jsou nejčastějšími léčivy způsobujícími alergické reakce v perioperačním období. Vzhledem k intravenóznímu podání léčiv během celkové anestezie mohou být tyto reakce potenciálně život ohrožující. V kazuistice popisujeme případ rokuroniem indukovaného anafylaktického šoku u 26leté ženy s podezřením na mimoděložní těhotenství úspěšně léčeného podáním sugammadexu.
Muscle relaxants are the most common cause of allergic reactions during the perioperative period. This reaction could be potentially life-threatening because of the intravenous route of administration of the drugs used for general anesthesia. We describe a case of rocuronium-induced anaphylactic shock in a 26-years-old woman with suspected extrauterine pregnancy successfully treated with sugammadex.
- MeSH
- Anaphylaxis * etiology drug therapy MeSH
- Adult MeSH
- Humans MeSH
- Pregnancy, Ectopic surgery MeSH
- Rocuronium * adverse effects MeSH
- Sugammadex administration & dosage therapeutic use MeSH
- Pregnancy MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Child MeSH
- Laparoscopy * MeSH
- Humans MeSH
- Neuromuscular Nondepolarizing Agents * MeSH
- Neuromuscular Blockade * adverse effects MeSH
- Pilot Projects MeSH
- Rocuronium MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Publication type
- Letter MeSH
- Randomized Controlled Trial MeSH
BACKGROUND: Onset times and conditions for intubation after rocuronium versus suxamethonium at cesarean section have been evaluated, but no study thus far has examined the influence of these neuromuscular blocking drugs on the surgical conditions or their effect on the duration of surgery and the ease of fetal delivery. We aimed to compare the surgical conditions for delivery in parturients who received deep neuromuscular block with rocuronium with those who had induction with suxamethonium. METHODS: Ninety patients undergoing cesarean section under general anesthesia were randomized to receive either rocuronium 0.6 mg/kg or suxamethonium 1 mg/kg for tracheal intubation and delivery. Times to delivery and the quality of surgical conditions, using a five-point Surgical Rating Scale for Delivery (SRSD) ranging from 1 (poor) to 5 (excellent), were evaluated. RESULTS: The median SRSD (range) was found to be significantly better in the rocuronium group [4 (3-5) points vs 3 (2-4) points with suxamethonium (P <0.001)]. Whereas the mean (SD) induction-to-intubation interval was longer with rocuronium [106 (34) s vs 68 (32) s with suxamethonium (95% CI of the difference 24 to 52 s, P <0.001)], the incision-to-delivery interval was shorter in the rocuronium group [147 (68) s vs 196 (51) s with suxamethonium (95% CI of the difference -75 to -24 s, P <0.001)]. The mean induction-to-delivery intervals were similar [268 (73) s vs 276 (63) s, respectively]. CONCLUSIONS: Whereas the induction-to-delivery intervals were comparable, we found rocuronium superior to suxamethonium in allowing better surgical conditions for fetal delivery, which enabled an easier delivery and a shorter incision-to-delivery interval.
- MeSH
- Time Factors MeSH
- Cesarean Section * MeSH
- Adult MeSH
- Double-Blind Method MeSH
- Humans MeSH
- Prospective Studies MeSH
- Rocuronium pharmacology MeSH
- Succinylcholine pharmacology MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Comparative Study MeSH
Periferní myorelaxancia jsou nedílnou součástí moderní anesteziologie. Zajišťují především usnadnění chirurgického výkonu a dobré podmínky k intubaci. Oproti minulosti, kdy byla pozornost stran nervosvalové blokády zaměřena právě na tyto aspekty, dominuje nyní zájem o monitoraci hloubky nervosvalové blokády v průběhu výkonu a její zvrat. Aktivní zvrat nervosvalové blokády za přítomné objektivní monitorace míry zotavení je důležitým bezpečnostním prvkem použití myorelaxancií. Článek přináší pohled především na aktuální trendy použití periferních svalových relaxancií.
Peripheral muscle relaxants are an integral part of modern anaesthesiology. They ensure, in particular, facilitation of the surgical procedure and good conditions for intubation. Unlike in the past, when attention in terms of neuromuscular blockade was paid to these very aspects, there now predominates an interest in monitoring the depth of neuromuscular blockade during the course of the procedure and its reversal. Active reversal of neuromuscular blockade in the presence of objective monitoring of the recovery rate is an important safety factor of muscle relaxant use. The article deals with the current trends in the use of peripheral muscle relaxants.
- MeSH
- Humans MeSH
- Neostigmine pharmacology adverse effects MeSH
- Neuromuscular Blockade methods adverse effects MeSH
- Neuromuscular Agents * history pharmacokinetics adverse effects MeSH
- Perioperative Period MeSH
- Rocuronium administration & dosage pharmacology MeSH
- Sugammadex administration & dosage pharmacology adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
AIMS: The purpose of this international survey was to describe the impact of current practices and techniques of caesarean section on the neonatal Apgar score in the Czech Republic (CZE) and Slovakia (SVK). METHODS: All Czech and Slovak departments that provide obstetric anaesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in details all peripartum anaesthetic practices, delivered by anaesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE). RESULTS AND DISCUSSIONS: We collected data of 10119 women who delivered 10226 newborns. A caesarean section was recorded in 25.1% of deliveries (CZE 23.2%; SVK 30%). General anaesthesia was used for caesarean section in 37.5% of the cases (CZE 40%, SVK 33%). There was no statistically significant difference in the Apgar score lower than 7 in the 1, 5 or 10 min in groups of general and regional anaesthesia for caesarean section, when only elective sections of in-term babies with birth weight over 2500 g were analyzed. We found no statistically significant differences in the Apgar score in newborns of women intubated for caesarean section in rocuronium (n=21; 2.2%) and suxamethonium (n=889; 93%). CONCLUSION: We found no difference in neonatal outcomes in groups of general and regional anaesthesia for caesarean section when only out-of-risk newborns were analyzed. The risk factors were identified as follows: an acute caesarean section, preterm babies, birth weight less than 2 500 g, born in perinatological center and multiple pregnancy - second baby. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT02380586) https://clinicaltrials.gov/ct2/show/NCT02380586.
- MeSH
- Apgar Score * MeSH
- Anesthesia, General statistics & numerical data MeSH
- Cesarean Section methods MeSH
- Neuromuscular Depolarizing Agents therapeutic use MeSH
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Neuromuscular Nondepolarizing Agents therapeutic use MeSH
- Infant, Newborn MeSH
- Anesthesia, Obstetrical MeSH
- Retrospective Studies MeSH
- Rocuronium therapeutic use MeSH
- Succinylcholine therapeutic use MeSH
- Anesthesia, Conduction statistics & numerical data MeSH
- Pregnancy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Infant, Newborn MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
- Slovakia MeSH
Myasthenia gravis postihuje nervosvalový přenos. Léčí se farmakologicky, imunologicky a thymektomií. Exacerbovat ji mohou operace, anestezie a další faktory. Nejbezpečnější technika znecitlivění není dosud stanovena. Doporučuje se anestezie pokud možno bez svalové relaxace – hluboká inhalační, nebo propofol a opioidy, či svodná anestezie. Jsou-li svalová relaxancia nutná k zajištění klidného operačního pole, hlavní problém představuje ovlivnění nervosvalového přenosu. Myastenici na relaxancia reagují nepředvídatelně kvůli změnám nervosvalové ploténky. Nejobávanější komplikací je prodloužený účinek znemožňující spontánní ventilaci spolu se zvýšeným rizikem aspirace a sníženou reakcí na hypoxii. Pak je možné pokračovat v umělé ventilaci do zotavení, klasická dekurarizace bývá omezeně účinná, může vyvolat cholinergní krizi. Novou možností je použít k relaxaci výhradně rokuronium a na konci sugammadex. Rokuronium a sugammadex představují nový, účinný a bezpečný přístup k celkové anestezii u myasteniků.
Myasthenia gravis impairs neuromuscular transmission. Its therapy is pharmacological, immunological and surgical by thymectomy. Surgery, anaesthesia and other factors can induce exacerbation of myasthenia. The safest technique of anaesthesia has not been determined. Anaesthesia without muscle relaxation recommended, either deep inhalational anaesthesia, or propofol with opioids, or regional anaesthesia. If neuromuscular blocking agents are needed to create a motionless surgical field, the main problem is neuromuscular transmission impairment. Myasthenic patients react on these agents unpredictably. The most feared complication is a prolonged effect preventing spontaneous ventilation with an increased risk of aspiration and a decreased reaction to hypoxia. In these circumstances mechanical ventilation can be continued. Pharmacological reversal can be attempted but it can induce a cholinergic crisis and its effect is usually limited. A new possibility is the use of rocuronium for muscle relaxation with reversal by sugammadex. Rocuronium and sugammadex could offer a new, effective and safe approach to general anaesthesia in myasthenic patients.
- MeSH
- Androstanols adverse effects therapeutic use MeSH
- Anesthetics, General adverse effects MeSH
- Anesthesia adverse effects MeSH
- Anesthesia, General * methods adverse effects MeSH
- Surgical Procedures, Operative * adverse effects MeSH
- Neuromuscular Depolarizing Agents adverse effects therapeutic use MeSH
- gamma-Cyclodextrins adverse effects therapeutic use MeSH
- Anesthesia, Inhalation methods adverse effects utilization MeSH
- Humans MeSH
- Myasthenia Gravis * surgery physiopathology MeSH
- Neuromuscular Nondepolarizing Agents adverse effects therapeutic use MeSH
- Neuromuscular Blockade adverse effects MeSH
- Motor Endplate physiopathology drug effects MeSH
- Anesthesia Recovery Period MeSH
- Respiratory Insufficiency chemically induced complications MeSH
- Rocuronium MeSH
- Sugammadex MeSH
- Thymectomy MeSH
- Respiration, Artificial MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Cíl studie: Srovnání postupů celkové anestezie se zaměřením na svalovou relaxaci v oblastní a fakultní nemocnici. Typ studie: Tříměsíční retrospektivní rozbor anesteziologických záznamů. Typ pracoviště: Anesteziologicko-resuscitační oddělení oblastní nemocnice, klinika anesteziologie, resuscitace a intenzivní medicíny fakultní nemocnice. Materiál a metoda: Během tříměsíčního období (září až listopad 2011) byly sledovány záznamy všech anesteziologických výkonů v oblastní (MB2011) a fakultní (FNOL2011) nemocnici, ve strukturované formě popsány: demografické údaje nemocných, typ a délka anesteziologické péče, zajištění dýchacích cest, svalová relaxace, reverze a monitorování bloku. Data mezi nemocnicemi porovnána (nepárový t-test, Fisherův přesný test, chí-kvadrát) na pětiprocentní hladině významnosti. Výsledky: Počet anesteziologických výkonů MB2011 2886, FNOL2011 4746. Celková anestezie byla poskytnuta častěji ve FNOL2011 (92,5 %) než v MB2011 (55,5 %, p < 0,0001), podíl regionální anestezie, případně s analgosedací činil v MB2011 27,3 %. V MB2011 byly nejčastější výkony kratší 60 minut (69,2 %), ve FNOL2011 výkony delší 60 minut (64,7 %). LMA byla požita častěji v MB2011 (26,5 %) než ve FNOL2011 (14,2 %, p < 0,0001). Více nemocných ve FNOL2011 bylo relaxováno (61,7 %), v MB2011 41,5 %, p < 0,0001. Nejčastějším relaxanciem bylo rokuronium (MB2011 88,5 %, FNOL2011 75,5 %, p < 0,0001). Hloubka relaxace byla monitorována u 52,1 % (MB2011), respektive 8,5 % nemocných (FNOL2011, p < 0,0001). Antagonizace bloku neostigminem u 89,8 % pacientů (MB2011) vs. 18,3 % (FNOL2011, p < 0,0001), průměrná dávka byla 0,024 ? 0,007 mg/kg (MB2011) vs. 0,019 ? 0,025 mg/kg (FNOL2011, p < 0,0001). Závěr: Prokázali jsme rozdíly v postupech anesteziologické péče mezi oblastní a fakultní nemocnicí. Klíčová slova: celková anestezie – dýchací cesty – svalová relaxace – reverze – monitorování
Objective: Comparison of general anaesthesia techniques focused on neuromuscular blockade in a regional and university hospitals. Design: Retrospective study, three-month analysis of anaesthesia charts. Setting: Departments of Anaesthesiology and Intensive Therapy of a regional and university hospitals. Materials and methods: Anaesthetic charts for all anae-stetic procedures performed in a regional (MB2011) and university (FNOL2011) hospitals during a 3-month period (September- November 2011) were analysed, focusing on patients‘ demographic data, type and lenght of anaesthesia, airway maintainance, neuromuscular blockade, techniques of block reversal and monitoring. The data were compared between the hospitals (unpaired t-test, Fisher exact, Chi-squared test) with statistical significance p < 0.05. Results: The total number of anaesthetic procedures performed in MB2011 was 2886, in FNOL2011 4746. General anaesthesia was more frequent in FNOL2011 (92.5%) than in MB2011 (55.5%, p < 0.0001), where 27.3% of procedures were performed in regional anaesthesia (alone or supplemented with analgosedation). Procedures lasting less than 60 minutes were more frequent in MB2011 (69.2%), whereas in FNOL2011 procedures lasting over 60 minutes prevailed (64.7%). LMA was used more often in MB2011 (26.5%) than in FNOL2011 (14.2%, p < 0.0001) for airway maintenance. Neuromuscular blockade was utilised more often in FNOL2011 (61.7%) than in MB2011 (41.5%, p < 0.0001). Rocuronium was the most frequently used NMBA (MB2011 88.5%, FNOL 75.5%, p < 0.0001). Depth of blockade was monitored in 52.1% patients in MB2011, compared to 8.5% patients in FNOL2011, p < 0.0001). Neuromuscular blockade was reversed with neostigmine in 89.8% patients (MB2011) vs. 18.3% (FNOL2011, p < 0.0001), with mean dose of 0.024 ? 0.007 mg/kg (MB2011) vs. 0.019 ? 0.025 mg/kg (FNOL2011, p < 0.0001). Conclusion: We observed differences in anaesthesia care procedures between a regional and university hospitals. Keywords: general anaesthesia – airway – neuromuscular blockade – reversal – monitoring
- Keywords
- reverze,
- MeSH
- Conscious Sedation statistics & numerical data MeSH
- Androstanols administration & dosage MeSH
- Time Factors MeSH
- Anesthesia, General * methods statistics & numerical data MeSH
- Muscle Relaxants, Central administration & dosage MeSH
- Surgical Procedures, Operative classification statistics & numerical data MeSH
- Anesthetics, Combined MeSH
- Laparoscopy statistics & numerical data MeSH
- Laryngeal Masks statistics & numerical data MeSH
- Humans MeSH
- Neuromuscular Nondepolarizing Agents administration & dosage MeSH
- Hospitals, Teaching * MeSH
- Hospitals, District * MeSH
- Neostigmine administration & dosage MeSH
- Neuromuscular Blocking Agents administration & dosage MeSH
- Monitoring, Intraoperative statistics & numerical data MeSH
- Health Care Surveys statistics & numerical data MeSH
- Retrospective Studies MeSH
- Rocuronium MeSH
- Chi-Square Distribution MeSH
- Statistics as Topic MeSH
- Anesthesia, Conduction methods statistics & numerical data MeSH
- Airway Management methods statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
Cíl: Zjistit rozsah použití myorelaxancií (NMBAs) v operačních oborech. Typ studie:Tříměsíční unicentrická retrospektivní observační studie rozborem anesteziologických záznamů (MBrelax2008). Pracoviště: Anesteziologicko-resuscitační oddělení regionální nemocnice. Materiál a metody: V operačních oborech sledovány – četnost celkové (CA) a regionální anestezie (RA), po - užití suxamethonia a nedepolarizujících NMBAs. Získané údaje porovnány s výsledky průřezové jednodenní národní studie Czech Anesthesia Day (CAD2010). Výsledky: Vyhodnoceno 2316 anesteziologických záznamů ze sledovaného období. CA podána v 72,6 % (CAD2010 92,9 %, p < 0,0001), nejčastěji na ORT/TRAUM (366; 48,8 %), CHIR (343; 80,3 %), URO (248; 72,9 %), ORL (306; 100 %), GPO (406; 84,4 %) a OČNÍM (12; 100 %). NMBAs použita u 634 pacientů (37,7% vs. 54,7% in CAD2010, p < 0,0001)), nejčastěji v CHIR (271; 79 %). LMA bez NMBA zavedena u 478 (28,4 %) pacientů, samotné suxamethonium použito u 33 pacientů (2 % CA), nejčastěji na GPO. Jen nedepolarizující NMBA u 471 pacientů (28 % CA) vs. u 684 (36,1 % CA) v CAD2010, p < 0,0001. Rokuronium použito častěji než cis - atrakurium (20,8 % vs. 13,8 %, p < 0,0001). Závěr: Ve srovnání s CAD2010 byl podíl výkonů v CA nižší a odráží častější použití RA. Rovněž počty relaxovaných pacientů byly nižší. Častěji byla používána LMA bez svalové relaxace. Z NMBAs bylo nejčastěji použito rokuronium. Výsledky ukazují na obtíže při interpretaci a porovnávání výsledků multicentrických průřezových studií stávající klinické praxe. Sledování anesteziologické péče je vhodné v delším časovém období a v menším počtu srovnatelných center.
Objective: Use of NMBAs in surgical anaesthesia. Design: Single-center, three-month analysis of anaesthesia charts (MBrelax2008). Setting: Department of Anaesthesiology and Intensive Care of a regional general hospital. Materials and methods:The observed parameters in surgical anaesthesia included the use of general anae - sthesia (GA), regional anaesthesia (RA), suxamethonium and non-depolarising NMBAs. The results were compared to data from the observational one-day Czech Anesthesia Day (CAD2010). Results: Total 2316 anaesthesia charts from the observed period were evaluated. GA was used in 72.6 % (CAD2010 92.9 %, p < 0.0001). Orthopaedics/Trauma (366; 48.8 %), General Surgery (343; 80.3 %), Urology (248; 72.9 %), ENT (306; 100 %), Gynae/Obstetrics (406; 84.4 %) and Ophthalmology (12; 100 %). NMBAs were administered to 634 patients (37.7% vs 54.7% in CAD2010, p < 0.0001), most often in G/S (271; 79 %). LMA was inserted without facilitation by NMBAs in 478 (28.4 %) patients. Suxamethonium alone was used in 33 patients (2 % GA) only, most frequently in G/O. In the MBrelax2008 study, non-depolarizing NMBAs only were administered to 471 patients (28 % GA) vs. 684 (36.1% GA) in CAD2010 (p < 0.0001). Rocuronium was administered more often than cisatracurium (20.8 % vs. 13.8 %, p < 0.0001). Conclusion: Comparing with CAD2010, surgery was performed under GA less frequently, reflecting increasing preference of RA in the center. This correlates with the lower use of NMBAs. LMA were more often inserted without NMBAs. Rocuronium is the most frequently used NMBA. The results point to the difficulties experienced when comparing the data from observational multi-center studies with current clinical practice. The data should be evaluated for longer periods and comparable centers.
- Keywords
- regionální anestezie, farmakoekonomika, NMBA, suxamethonium, cisatrakurium,
- MeSH
- Androstanols administration & dosage MeSH
- Atracurium analogs & derivatives administration & dosage MeSH
- Anesthesia, General methods statistics & numerical data MeSH
- Muscle Relaxants, Central administration & dosage MeSH
- Surgical Procedures, Operative MeSH
- Data Interpretation, Statistical MeSH
- Laryngeal Masks statistics & numerical data MeSH
- Humans MeSH
- Neuromuscular Nondepolarizing Agents administration & dosage MeSH
- Hospital Departments MeSH
- Neuromuscular Blocking Agents administration & dosage therapeutic use MeSH
- Health Care Surveys statistics & numerical data MeSH
- Retrospective Studies MeSH
- Rocuronium MeSH
- Statistics as Topic MeSH
- Succinylcholine administration & dosage MeSH
- Anesthesia, Conduction methods statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Publication type
- Comparative Study MeSH
- Geographicals
- Czech Republic MeSH
Sugammadex je nová látka, určená k reverzi nervosvalového bloku po podání rokuronia nebo vekuronia. Ve srovnání s neostigminem má odlišný mechanismus účinku (enkapsulace), který nezávisí na enzymatické aktivitě cholinesterázy. Na základě medicíny založené na důkazech autoři shrnují současné indikace sugammadexu, jeho výhody i význam při specifických situacích během anestezie.
Sugammadex is a novel drug for reversal of rocuronium or vecuronium-induced neuromuscular blockade. Compared to neostigmine, its mechanism of action (encapsulation) is not influenced by cholinesterase activity. In this article, the authors summarize the current indications of sugammadex, its advantages over neostigmine and its value in specific situations during anaesthesia.
- Keywords
- nervosvalový blok, enkapsulace, rocuronium, encapsulation,
- MeSH
- Androstanols antagonists & inhibitors therapeutic use MeSH
- Anesthesia methods MeSH
- gamma-Cyclodextrins * pharmacology therapeutic use MeSH
- Drug Evaluation MeSH
- Humans MeSH
- Evidence-Based Medicine MeSH
- Neuromuscular Nondepolarizing Agents antagonists & inhibitors therapeutic use MeSH
- Neuromuscular Blockade * methods MeSH
- Rocuronium MeSH
- Sugammadex MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
Cíl studie: Popis antagonizace mělkého bloku po rokuroniu podáním sugammadexu. Typ studie: Klinická, observační, retrospektivní, neintervenční. Typ pracoviště: Klinika anesteziologie a resuscitace fakultní nemocnice. Materiál a metoda: Retrospektivně jsme vyhodnotili průběh svalové relaxace po antagonizaci účinku rokuronia sugammadexem (2 mg . kg-1) u nemocných v doplňované anestezii plánované délky 45–60 minut. Nervosvalový přenos jsme měřili přístrojem TOF-Watch® SX (stimulace loketního nervu každých 15 s v režimu TOF, akcelerometrické stanovení odpovědi m. adductor pollicis). Po spontánním zotavení z nervosvalového bloku na TOF-count = 2 jsme podali sugammadex (2 mg . kg-1). Data (TOF-ratio, T1) jsme optickým kabelem přenášeli do počítače, popsali deskriptivními statistickými metodami a znázornili graficky. Výsledky: Analyzovali jsme data od 18 mužů a 14 žen, průměrného věku 46 let, hmotnosti 74 kg, výšky 170 cm a BMI 25,84 kg . m-2. Anestezie trvala průměrně 64 minut. Při spontánním odeznívání bloku se reakce na druhý impulz TOF (TOF-count = 2) objevila při průměrné hodnotě T1 = 19 %. Medián (horní a dolní kvartil) do adekvátního zotavení z bloku (TOF-ratio ? 0,9) byl 97,5 s (75; 130) od podání sugammadexu. Dostatečné zotavení z bloku nastalo u 13 % nemocných do jedné minuty, u 72 % nemocných do 2 minut a u všech nemocných do 3 minut od podání sugammadexu. Nezaznamenali jsme nežádoucí účinky spojené s aplikací sugammadexu. Závěr: Sugammadex (2 mg . kg-1) spolehlivě antagonizuje mělký blok (TOF-count = 2) po podání rokuronia. Adekvátního zotavení se dosáhne do tří minut po aplikaci sugammadexu.
Objective:To study the reversal of moderate rocuronium-induced neuromuscular block as part of balanced general anaesthesia with sugammadex 2 mg/kg. Design: Clinical, observational, retrospective, non-interventional study. Setting: Department of Anaesthesiology, University Hospital. Materials and methods: The reversal of moderate rocuronium-induced neuromuscular block with sugammadex (2 mg/kg) was retrospectively studied. We used TOF stimulation of the ulnar nerve at 15-s intervals and measured the accelerometric response of the adductor pollicis muscle (TOF-Watch® SX). Following spontaneous recovery to TOF-count = 2, sugammadex (2 mg/kg) was administered and the reversal of the block was recorded. We transferred the data (TOF-ratio, T1) via a link to the computer and presented the results using descriptive statistics and graphs. Results:We analysed the data from 18 males and 14 females. The mean age was 46 years, mean weight 74 kg, mean height 170 cm and mean BMI 25.84 kg/m2. The mean duration of anaesthesia was 64 minutes. Du - ring spontaneous recovery from the block, the reaction to the second impulse in TOF (TOF-count = 2) was detected as early as T1 = 19 %. Median (quartiles) of time to full recovery (TOF-ratio ? 0.9) was 97.5 (75; 130) s following sugammadex administration. Full recovery was observed in 13 % patients at 1 minute, in 72 % at 2 minutes and in all the patients at 3 minutes. No adverse effects following sugammadex admini - stration were observed. Conclusion: Following sugammadex (2 mg/kg) administration, the reversal of moderate rocuronium-induced block was reliable and full recovery was reached within 3 minutes of sugammadex administration.
- Keywords
- antagonizace,
- MeSH
- Androstanols administration & dosage therapeutic use MeSH
- Anesthesia, General methods utilization MeSH
- gamma-Cyclodextrins administration & dosage therapeutic use MeSH
- Humans MeSH
- Midazolam administration & dosage therapeutic use MeSH
- Neostigmine administration & dosage adverse effects therapeutic use MeSH
- Neuromuscular Blockade methods utilization MeSH
- Neuromuscular Agents antagonists & inhibitors administration & dosage therapeutic use MeSH
- Propofol administration & dosage therapeutic use MeSH
- Muscle Relaxation drug effects MeSH
- Retrospective Studies MeSH
- Rocuronium MeSH
- Statistics as Topic MeSH
- Sufentanil administration & dosage therapeutic use MeSH
- Sugammadex MeSH
- Outcome and Process Assessment, Health Care MeSH
- Check Tag
- Humans MeSH
