Brazilian journal of anesthesiology (Elsevier) · 2020
[Influence of methylprednisolone on the reversal time of sugammadex: a randomized clinical trial].
Сравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Kocaoğlu Merve Hayriye, Meço Başak Ceyda, Özçelik Menekşe, Batislam Yeşim
Аннотация
BACKGROUND AND OBJECTIVES: Sugammadex is a modified gamma-cyclodextrin that reverses the effects of aminosteroidal neuromuscular blocking agents. Likewise, some steroid molecules, such as toremifene, fusidic acid, and flucloxacillin, can also be encapsulated by sugammadex. Methylprednisolone, which is a synthetic steroid used commonly for airway edema prophylaxis, can also be encapsulated by sugammadex. The objective of this study was to compare the recovery times of sugammadex for reversing rocuronium-induced moderate neuromuscular blockade in those who received intraoperative 1 mg kg−1 methylprednisolone or saline.
METHOD: This single-centered, randomized, controlled, prospective study included 162 adult patients undergoing elective ear-nose-throat procedures (aged from 18 to 65, an ASA physical status I-II, a BMI less than 30 kg m−2, and not taking steroid drug medication) with propofol, remifentanyl, rocuronium and sevoflurane. Neuromuscular monitoring was performed using calibrated acceleromyography. The Control Group (Group C) received 5 mL of saline, while the Methylprednisolone Group (Group M) received 1 mg kg−1 of methylprednisolone in 5 mL of saline just after induction. After the completion of surgery, regarding the TOF count, two reappeared spontaneously and 2 mg kg−1 sugammadex was administered to all patients. Recovery of the TOF ratio to 0.9 was recorded for both groups, and the estimated recovery time to reach a TOF ratio (TOFr) of 0.9 was the primary outcome of the study.
RESULTS: Median time to TOFr = 0.9 was for 130.00 s (range of 29–330) for Group C and 181.00 s (100–420) for Group M (p < 0.001). The differences between the two groups were statistically significant.
CONCLUSION: When using 2 mg kg−1 of sugammadex to reverse rocuronium-induced neuromuscular blockade in patients who received 1 mg kg−1 of intraoperative methylprednisolone, demonstrated delayed recovery times.
METHOD: This single-centered, randomized, controlled, prospective study included 162 adult patients undergoing elective ear-nose-throat procedures (aged from 18 to 65, an ASA physical status I-II, a BMI less than 30 kg m−2, and not taking steroid drug medication) with propofol, remifentanyl, rocuronium and sevoflurane. Neuromuscular monitoring was performed using calibrated acceleromyography. The Control Group (Group C) received 5 mL of saline, while the Methylprednisolone Group (Group M) received 1 mg kg−1 of methylprednisolone in 5 mL of saline just after induction. After the completion of surgery, regarding the TOF count, two reappeared spontaneously and 2 mg kg−1 sugammadex was administered to all patients. Recovery of the TOF ratio to 0.9 was recorded for both groups, and the estimated recovery time to reach a TOF ratio (TOFr) of 0.9 was the primary outcome of the study.
RESULTS: Median time to TOFr = 0.9 was for 130.00 s (range of 29–330) for Group C and 181.00 s (100–420) for Group M (p < 0.001). The differences between the two groups were statistically significant.
CONCLUSION: When using 2 mg kg−1 of sugammadex to reverse rocuronium-induced neuromuscular blockade in patients who received 1 mg kg−1 of intraoperative methylprednisolone, demonstrated delayed recovery times.