Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
J Clin Anesth. 2019 Nov;57:97-102. doi: 10.1016/j.jclinane.2019.02.014. Epub 2019 Mar 30.
To evaluate the influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium after pars plana vitrectomy (PPV) under general anesthesia.
Prospective, double-blind, randomized controlled trial.
This study was conducted in a University Teaching Hospital from February to July 2017.
A total of 84 patients with an American Society of Anesthesiologists physical status of I or II who were scheduled to undergo PPV under general anesthesia.
The patients were randomly assigned to the neostigmine (Group N, n = 44) or sugammadex (Group S, n = 40) groups; 3 ml of study drug was prepared for the patients. For patients in Group N, a solution of neostigmine methylsulfate (1 mg) and glycopyrrolate (0.2 mg) was prepared, while a solution of sugammadex sodium (2 mg/kg) and normal saline was prepared for patients in Group S.
The primary endpoint was the effect of sugammadex, compared with neostigmine, on the recovery rate in the physiological domain in patients who underwent PPV with general anesthesia. The quality of recovery was assessed using the Postoperative Quality Recovery Scale at 15 min and 40 min after surgery, and on postoperative day 1.
The recovery rate in the physiological domain was higher in Group S at 15 min after surgery (P = 0.020). Though there were no significant differences in the overall cognitive recovery domain, patients in Group S could recall more numbers in reverse order. However, there were no significant differences between the groups in the other domains of the scale.
The use of sugammadex may increase the quality of physiological recovery at early postoperative periods, compared with that of neostigmine, following a single bolus dose of rocuronium in patients undergoing PPV with general anesthesia.
Registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT03108989). Registration number: NCT03108989.
评估在全身麻醉下接受单次罗库溴铵推注行玻璃体切除术（PPV）后，使用琥珀酸舒更葡糖或新斯的明逆转神经肌肉阻滞对术后恢复质量的影响。
前瞻性、双盲、随机对照试验。
本研究于 2017 年 2 月至 7 月在一所大学教学医院进行。
共有 84 名美国麻醉医师协会（ASA）身体状况 I 或 II 级的患者，计划在全身麻醉下接受 PPV。
患者被随机分配到新斯的明（N 组，n=44）或琥珀酸舒更葡糖（S 组，n=40）组；为患者准备 3ml 研究药物。对于 N 组的患者，准备硫酸新斯的明（1mg）和格隆溴铵（0.2mg）的溶液，而 S 组的患者准备琥珀酸舒更葡糖钠（2mg/kg）和生理盐水的溶液。
主要终点是与新斯的明相比，琥珀酸舒更葡糖对接受全身麻醉下 PPV 的患者在生理域的恢复率的影响。使用术后恢复质量量表在术后 15 分钟和 40 分钟以及术后第 1 天评估恢复质量。
术后 15 分钟时 S 组的生理域恢复率更高（P=0.020）。虽然在总体认知恢复域没有显著差异，但 S 组的患者可以回忆起更多倒序的数字。然而，两组在量表的其他域中没有显著差异。
与新斯的明相比，在全身麻醉下接受单次罗库溴铵推注行 PPV 的患者中，使用琥珀酸舒更葡糖可能会增加早期术后生理恢复的质量。
在 ClinicalTrials.gov 注册（https://clinicaltrials.gov/ct2/show/NCT03108989）。注册号：NCT03108989。
