Cammu G, Coart D, De Graeve K, Beelen R
Department of Anesthesiology and Critical Care Medicine, Onze-Lieve-Vrouw Ziekenhuis, Aalst, Belgium.
Acta Anaesthesiol Belg. 2012;63(2):69-73.
The aim of this study was to assess the hemodynamic stability and efficacy of 2 mg/kg sugammadex in reversing rocuronium-induced neuromuscular block in patients with heart failure. Twelve patients who had an ejection fraction < or = 25% and who were undergoing general anesthesia for cardiac resynchronization therapy, an automated implantable cardioverter-defibrillator, or battery replacement of the device were included. Neuromuscular function was monitored by acceleromyography of the adductor pollicis muscle. Each patient received 0.6 mg/kg of rocuronium and maintenance doses of 0.1 mg/kg when required. When the second twitch appeared at the end of surgery, the patients received 2 mg/kg sugammadex. After the administration of sugammadex, the time for recovery to a normalized train-of-four (TOF) ratio of 0.9 was 2.78 +/- 0.67 min. Blood pressure and heart rate remained stable up to 10 min after the administration of sugammadex and then increased by the 30-min assessment. Three patients had episodes of SpO2 < 90% in the postanesthesia care unit. No sugammadex-related adverse events were reported. Sugammadex can adequately restore neuromuscular function in heart failure patients under hemodynamically stable conditions. However, longer reversal times are required than previously observed in healthy, young patients.
本研究旨在评估2mg/kg舒更葡糖在逆转心力衰竭患者罗库溴铵诱导的神经肌肉阻滞方面的血流动力学稳定性和疗效。纳入了12例射血分数≤25%且正在接受心脏再同步治疗、植入式自动心脏除颤器或设备电池更换的全身麻醉患者。通过拇内收肌加速度肌电图监测神经肌肉功能。每位患者接受0.6mg/kg的罗库溴铵，并在需要时给予0.1mg/kg的维持剂量。当手术结束时出现第二个肌颤搐时，患者接受2mg/kg的舒更葡糖。给予舒更葡糖后，恢复到标准化四个成串刺激（TOF）比值0.9的时间为2.78±0.67分钟。给予舒更葡糖后长达10分钟血压和心率保持稳定，然后在30分钟评估时升高。3例患者在麻醉后护理单元出现SpO2<90%的情况。未报告与舒更葡糖相关的不良事件。舒更葡糖可在血流动力学稳定的情况下充分恢复心力衰竭患者的神经肌肉功能。然而，与之前在健康年轻患者中观察到的情况相比，需要更长的逆转时间。
