Motamed Cyrus, Bourgain Jean Louis
Department of Anesthesia, Institut Gustave Roussy, 94080 Villejuif, France.
J Clin Med. 2021 Feb 17;10(4):815. doi: 10.3390/jcm10040815.
Sugammadex provides a rapid pharmacological reversal of aminosteroid, as well as fewer pulmonary complications, a better physiological recovery, and shorter stays in the postanesthetic recovery unit (PACU). This retrospective analysis of our Centricity anesthesia database in 2017-2019 assessed the efficiency of sugammadex in real-life situations in two groups of surgical cancer patients (breast and abdominal surgery) based on the extubation time, operating room exit time, and length of PACU stay. Overall, 382 anesthesia records (131 breast and 251 abdominal surgeries) were extracted for the pharmacological reversal of neuromuscular blockades by neostigmine or sugammadex. Sugammadex was used for reversal in 91 breast and 204 abdominal surgeries. Sugammadex use did not affect the extubation time, operating room exit time, or length of PACU stay. However, the time to reach a 90% train of four (TOF) recovery was significantly faster in sugammadex patients: 2 min (1.5-8) in breast surgery and 2 min (1.5-7) in abdominal surgery versus 10 (6-20) and 9 min (5-20), respectively, for neostigmine ( < 0.05). Most patients who were reversed with sugammadex (91%) reached a TOF ratio of at least 90%, while 54% of neostigmine patients had a 90% TOF ratio recorded ( < 0.05). Factors other than pharmacological reversal probably influence the extubation time, operating room exit time, or PACU stay; however, sugammadex reliably shortened the time so as to reach a 90% TOF ratio with a better level of reversal.
舒更葡糖钠可迅速实现氨基甾体类药物的药理学逆转，且肺部并发症更少、生理恢复更好、在麻醉后恢复室（PACU）的停留时间更短。本研究对我们2017 - 2019年的Centricity麻醉数据库进行回顾性分析，基于拔管时间、手术室离开时间和PACU停留时长，评估舒更葡糖钠在两组外科癌症患者（乳房手术和腹部手术）实际临床中的有效性。总体而言，提取了382份麻醉记录（131例乳房手术和251例腹部手术）用于新斯的明或舒更葡糖钠对神经肌肉阻滞的药理学逆转。舒更葡糖钠用于91例乳房手术和204例腹部手术的逆转。使用舒更葡糖钠并未影响拔管时间、手术室离开时间或PACU停留时长。然而，使用舒更葡糖钠的患者达到四个成串刺激（TOF）90%恢复的时间明显更快：乳房手术为2分钟（1.5 - 8分钟），腹部手术为2分钟（1.5 - 7分钟），而新斯的明组分别为1起0分钟（分钟（6 - 20分钟）和9分钟（5 - 20分钟）（P<0.05）。大多数用舒更葡糖钠逆转的患者（91%）达到了至少90%的TOF比值，而新斯的明组患者中有54%记录到90%的TOF比值（P<0.05）。除药理学逆转外的其他因素可能影响拔管时间、手术室离开时间或PACU停留时长；然而，舒更葡糖钠确实可靠地缩短了达到90%TOF比值的时间，且逆转水平更好。
