Department of Anesthesiology, Wenzhou Central Hospital, Wenzhou, China.
Department of Anesthesiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.
J Cardiothorac Vasc Anesth. 2021 May;35(5):1388-1392. doi: 10.1053/j.jvca.2020.08.069. Epub 2020 Sep 3.
The purpose of this study was to evaluate the safety and efficacy of sugammadex for fast-track surgery in children undergoing cardiac surgery.
This was a prospective, randomized, controlled clinical study.
University hospital.
The study comprised 60 children undergoing cardiac surgery.
The children in group S received sugammadex, 4 mg/kg, for reversal of neuromuscular block, and the children in group N received neostigmine, 30 µg/kg, and atropine, 15 µg/kg.
The recovery time to a train-of-four of 0.9 and extubation time were significantly shorter in the group S than in group N (3.4 ± 1.2 min v 76.2 ± 20.5 min and 31.0 ± 6.4 min v 125.2 ± 21.6 min, respectively; p < 0.01). The heart rate after drug administration was higher in group S than in group N (102.7 ± 9.4 beats/min v 96.9 ± 8.5 beats/min; p = 0.03), whereas the mean arterial pressure after drug administration was similar in both groups. The length of hospital stay was shorter in group S (5.8 ± 1.0 v 6.5 ± 0.9 days; p = 0.03), and the hospitalization expenses were decreased in group S compared with that of group N ($1,036 ± $114 v $1,286 ± $187; p < 0.01). The incidence of postoperative atelectasis was less in group S than in group N (0 v 20%; p = 0.024).
Sugammadex can shorten the extubation time and reduce the incidence of postoperative atelectasis, with fewer adverse events, in children undergoing cardiac surgery. It may be beneficial to use sugammadex for fast-track surgery in children undergoing cardiac surgery.
本研究旨在评估琥乙红霉素在儿童心脏手术快速康复中的安全性和有效性。
这是一项前瞻性、随机、对照临床试验。
大学医院。
本研究纳入 60 例行心脏手术的儿童。
S 组患儿给予琥乙红霉素 4mg/kg 逆转神经肌肉阻滞,N 组患儿给予新斯的明 30μg/kg 和阿托品 15μg/kg。
S 组患儿的肌松恢复至 0.9 个成串刺激(TOF)的时间和拔管时间明显短于 N 组(3.4±1.2min 比 76.2±20.5min 和 31.0±6.4min 比 125.2±21.6min;p<0.01)。S 组患儿用药后心率高于 N 组(102.7±9.4 次/min 比 96.9±8.5 次/min;p=0.03),而两组患儿用药后的平均动脉压相似。S 组患儿的住院时间短于 N 组(5.8±1.0d 比 6.5±0.9d;p=0.03),且 S 组患儿的住院费用低于 N 组(1036±114 美元比 1286±187 美元;p<0.01)。S 组患儿术后肺不张的发生率低于 N 组(0%比 20%;p=0.024)。
琥乙红霉素可缩短儿童心脏手术后的拔管时间,降低术后肺不张的发生率,且不良事件更少。对于行心脏手术的儿童,快速康复方案中使用琥乙红霉素可能有益。