John Julie, Perry Greg, Perry Jeremie, Guttenberg Viktoria, Asonganyi Nicole, Laheji Sana, Raza Jaffar, Hall Ronald G
Hendrick Medical Center.
Texas Tech University Health Sciences Center, School of Pharmacy.
Innov Pharm. 2020 Jul 31;11(3). doi: 10.24926/iip.v11i3.3329. eCollection 2020.
The purpose of this study was to evaluate the impact of sugammadex on operating room (OR) times versus neostigmine in patients recovering from rocuronium or vecuronium induced neuromuscular blockade.
This retrospective cohort study evaluated patients 18 years or older with an American Society of Anesthesiologists (ASA) physical status of I-III who received sugammadex or neostigmine (January- October 2017) for reversal of rocuronium or vecuronium at a 500 bed, community hospital. Patients who were pregnant or breastfeeding were excluded. The primary outcome measure was the time from sugammadex or neostigmine administration to OR exit. The primary outcome was evaluated using a linear regression model adjusting for inpatient procedures, age, sex, body mass index, and ASA score. Secondary outcomes included the incidence of bradycardia as well as nausea and vomiting.
The baseline characteristics of the patients in the cohort (sugammadex=134, neostigmine=143) were similar. The median time from drug administration to OR exit was similar for neostigmine and sugammadex (16 vs. 15.5 minutes, p=0.11). Sugammadex had a statistically significant reduction in time from drug administration to OR exit (coefficient -2.7 minutes, 95% confidence interval -5.2 to -0.2 minutes) in the multivariable linear regression model. Sugammadex had lower rates of bradycardia (5.6 vs. 2.2%) or nausea and vomiting (18 vs. 11%) that did not reach statistical significance.
Sugammadex had statistically shorter OR exit times after drug administration in the cohort. The mean 2.7 minute benefit is unlikely to be clinically meaningful and limits its application in practice unless larger cohorts detect a benefit due to a significant reduction.in.adverse.events.
本研究旨在评估舒更葡糖钠与新斯的明相比，对罗库溴铵或维库溴铵诱导的神经肌肉阻滞恢复患者手术室（OR）时间的影响。
这项回顾性队列研究评估了年龄在18岁及以上、美国麻醉医师协会（ASA）身体状况为I - III级的患者，这些患者于2017年1月至10月在一家拥有500张床位的社区医院接受舒更葡糖钠或新斯的明用于罗库溴铵或维库溴铵的逆转。排除怀孕或哺乳期患者。主要结局指标是从给予舒更葡糖钠或新斯的明到离开手术室的时间。使用线性回归模型评估主要结局，并对住院手术、年龄、性别、体重指数和ASA评分进行调整。次要结局包括心动过缓以及恶心和呕吐的发生率。
队列中患者（舒更葡糖钠组 = 134例，新斯的明组 = 143例）的基线特征相似。新斯的明和舒更葡糖钠从给药到离开手术室的中位时间相似（16分钟对15.5分钟，p = 0.11）。在多变量线性回归模型中，舒更葡糖钠从给药到离开手术室的时间有统计学显著缩短（系数 -2.7分钟，95%置信区间 -5.2至 -0.2分钟）。舒更葡糖钠的心动过缓发生率（5.6%对2.2%）或恶心和呕吐发生率（18%对11%）较低，但未达到统计学显著性。
在队列中，舒更葡糖钠给药后离开手术室的时间在统计学上更短。平均2.7分钟的获益在临床上可能无意义，限制了其在实践中的应用，除非更大的队列由于不良事件显著减少而检测到获益。
