Department of Anesthesiology and Reanimation, Faculty of Medicine, Düzce University, Düzce, Turkey
Department of Anesthesiology and Reanimation, Medipol University Mega Hospital Complex, İstanbul, Turkey
Turk J Med Sci. 2020 Jun 23;50(4):749-755. doi: 10.3906/sag-1901-115.
BACKGROUND/AIM: This study is aimed to investigate the effects of vitamin D levels on sugammadex and neostigmine reversal times.
Eighty patients between the ages of 18 and 65 years, with ASA I-III status who were undergoing surgery under general anesthesia were included in the study. A double blind fashion was used to randomly divide all the patients into two groups. At the end of the operation, sugammadex 2 mg/kg was administered to one group (Group sugammadex) and atropine and neostigmine was administered to the other group (Group neostigmine) intravenously. In the data analysis stage, the group was divided into two subgroups according to sugammadex and group neostigmine in itself, with vitamin D levels above and below 30 ng/mL. Statistical analysis was performed on these 4 groups (Group neostigmine and vitamin D < 30 ng/mL), (Group neostigmine and vitamin D ≥ 30 ng/mL), ( Group sugammadex and vitamin D < 30 ng/mL), (Group sugammadex and vitamin D ≥ 30 ng/mL). When two responses to train of four (TOF) stimulation were taken, the following times were recorded until extubation phase. The time until TOF value 50%, 70%, 90%, and extubation were recorded.
There were statistically significant differences between Group sugammadex and vitamin D < 30 ng/mL and Group sugammadex and vitamin D ≥ 30 ng/mL (P = 0.007) for extubation times and 50% TOF reach times (P = 0.015). However, there was no difference observed between Group neostigmine and vitamin D < 30 ng/mL and Group neostigmine and vitamin D ≥ 30 ng/mL (P = 0.999).
Vitamin D deficiency is important for anesthesiologists in terms of muscle strength and extubation time. Vitamin D deficiency seems to affect sugammadex reverse times but seems not to affect neostigmine reverse times. This conclusion needs further studies.
背景/目的:本研究旨在探讨维生素 D 水平对舒更葡糖钠和新斯的明逆转时间的影响。
将 80 名年龄在 18 至 65 岁之间、ASA I-III 级的手术患者纳入研究。采用双盲法将所有患者随机分为两组。在手术结束时,一组患者(舒更葡糖钠组)静脉注射 2mg/kg 的舒更葡糖钠,另一组患者(新斯的明组)静脉注射阿托品和新斯的明。在数据分析阶段,根据舒更葡糖钠和新斯的明本身,将该组分为两组,维生素 D 水平高于和低于 30ng/ml。对这 4 组(新斯的明组和维生素 D <30ng/ml)、(新斯的明组和维生素 D ≥30ng/ml)、(舒更葡糖钠组和维生素 D <30ng/ml)、(舒更葡糖钠组和维生素 D ≥30ng/ml)进行了统计学分析。当对四串刺激(TOF)进行两次反应时,记录直到拔管阶段的以下时间。记录达到 TOF 值 50%、70%、90%和拔管的时间。
舒更葡糖钠和维生素 D <30ng/ml 组与舒更葡糖钠和维生素 D ≥30ng/ml 组的拔管时间和 50%TOF 到达时间有统计学显著差异(P=0.007)(P=0.015)。然而,新斯的明和维生素 D <30ng/ml 组与新斯的明和维生素 D ≥30ng/ml 组之间无差异(P=0.999)。
维生素 D 缺乏对麻醉师的肌肉力量和拔管时间很重要。维生素 D 缺乏似乎会影响舒更葡糖钠的逆转时间,但似乎不会影响新斯的明的逆转时间。这一结论需要进一步研究。