Department of Anesthesiology and Pain Medicine, Haeundae Paik Hospital of Inje University, 875 Haeun-daero, Haeundae-gu, Busan KS012, Korea.
Medicina (Kaunas). 2021 Jan 21;57(2):88. doi: 10.3390/medicina57020088.
: The harmonization of recovery of consciousness and muscular function is important in emergence from anesthesia. Even if muscular function is recovered, tracheal extubation without adequate recovery of consciousness may increase the risk of respiratory complications. In particular, upper airway obstruction is one of the common respiratory complications and can sometimes be fatal. However, the association between the timing of sugammadex administration and the upper airway obstruction that can occur during awakening from anesthesia has rarely been studied. : The medical records of 456 patients who had surgery under general endotracheal anesthesia (GETA) at the Haeundae Paik Hospital between October 2017 and July 2018 and who received intravenous sugammadex to reverse rocuronium-induced neuromuscular blockade were analyzed. The correlations between bispectral index (BIS) and minimum alveolar concentration (MAC) at the time of sugammadex administration, the incidence of complications, and the time to tracheal extubation were analyzed to investigate how different timings of sugammadex administration affected upper airway obstruction after tracheal extubation. : The effect of BIS and the duration from anesthetic discontinuation to sugammadex administration on upper airway obstruction was not statistically significant. However, the odds ratio of complication rates with MAC < 0.3 compared with MAC ≥ 0.3 was 0.40 (95% confidence interval 0.20 to 0.81, = 0.011), showing a statistically significant increase in risk with MAC ≥ 0.3 for upper airway obstruction.
: 在麻醉苏醒过程中，意识和肌肉功能的恢复协调非常重要。即使肌肉功能得到恢复，如果在意识没有充分恢复的情况下进行气管拔管，可能会增加呼吸并发症的风险。特别是，上呼吸道梗阻是常见的呼吸并发症之一，有时可能是致命的。然而，很少有研究探讨舒更葡糖钠给药时机与麻醉苏醒期间可能发生的上呼吸道梗阻之间的关系。: 对 2017 年 10 月至 2018 年 7 月期间在海云台白医院接受全身气管内麻醉（GETA）手术且静脉注射舒更葡糖钠逆转罗库溴铵诱导的神经肌肉阻滞的 456 例患者的病历进行了分析。分析了舒更葡糖钠给药时的脑电双频指数（BIS）和肺泡最低有效浓度（MAC）之间的相关性、并发症发生率以及气管拔管时间，以探讨舒更葡糖钠给药时间的不同如何影响气管拔管后上呼吸道梗阻。: BIS 和从麻醉停止到舒更葡糖钠给药的时间对上呼吸道梗阻的影响没有统计学意义。然而，MAC < 0.3 与 MAC ≥ 0.3 时并发症发生率的比值比为 0.40（95%置信区间 0.20 至 0.81， = 0.011），表明 MAC ≥ 0.3 时上呼吸道梗阻的风险显著增加。
