Lee Il Ok, Kim Young Sung, Chang Hae Wone, Kim Heezoo, Lim Byung Gun, Lee Mido
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
BMC Anesthesiol. 2018 May 24;18(1):56. doi: 10.1186/s12871-018-0519-3.
Previous studies have shown that sugammadex resulted in the prolongation of prothrombin time and activated partial thromboplastin time. In this study, we aimed to investigate the in vitro effects of exogenous sugammadex on the coagulation variables of whole blood in healthy patients who underwent orthopedic surgery.
The effects of sugammadex on coagulations were assessed using thromboelastography (TEG) in kaolin-activated citrated blood samples taken from 14 healthy patients who underwent orthopedic surgery. The in vitro effects of three different concentrations of sugammadex (42, 193, and 301 μg mL) on the TEG profiles were compared with those of the control (0 μg mL). Previous studies indicated that these exogenous concentrations correspond to the approximate maximum plasma concentrations achieved after the administration of 4, 16, and 32 mg kg sugammadex to healthy subjects.
Increased sugammadex concentrations were significantly associated with reduced coagulation, as evidenced by increases in reaction time (r), coagulation time, and time to maximum rate of thrombus generation (TMRTG), and decreases in the angle, maximum amplitude, and maximum rate of thrombus generation. Compared with the control, the median percentage change (interquartile range) in the TEG values of the samples treated with the highest exogenous sugammadex concentration was the greatest for r, 53% (26, 67.3%), and TMRTG, 48% (26, 59%).
This in vitro study suggests that supratherapeutic doses of exogenous sugammadex might be associated with moderate hypocoagulation in the whole blood of healthy subjects.
identifier: UMIN000029081 , registered 11 September 2017.
既往研究表明，舒更葡糖钠可导致凝血酶原时间和活化部分凝血活酶时间延长。在本研究中，我们旨在调查外源性舒更葡糖钠对接受骨科手术的健康患者全血凝血指标的体外影响。
采用血栓弹力图（TEG）评估舒更葡糖钠对凝血的影响，样本取自14例接受骨科手术的健康患者的高岭土激活枸橼酸化血液样本。将三种不同浓度（42、193和301μg/mL）的舒更葡糖钠对TEG曲线的体外影响与对照组（0μg/mL）进行比较。既往研究表明，这些外源性浓度分别对应于健康受试者静脉注射4、16和32mg/kg舒更葡糖钠后达到的近似最大血浆浓度。
舒更葡糖钠浓度升高与凝血功能降低显著相关，反应时间（r）、凝血时间和血栓形成最大速率时间（TMRTG）增加，角度、最大振幅和血栓形成最大速率降低。与对照组相比，外源性舒更葡糖钠浓度最高的样本TEG值的中位数变化百分比（四分位间距）在r方面最大，为53%（26，67.3%），TMRTG方面为48%（26，59%）。
这项体外研究表明，超治疗剂量的外源性舒更葡糖钠可能与健康受试者全血的中度低凝状态有关。
标识符：UMIN000029081，于2017年9月11日注册。
