Saber Hosam I El Said, Mousa Sherif A, AbouRezk Ahmed Refaat, Zaglool A
Department of Anesthesiology and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Anesth Essays Res. 2021 Jul-Sep;15(3):272-278. doi: 10.4103/aer.aer_139_21. Epub 2022 Feb 7.
Sugammadex is a selective reversal agent which has the ability to reverse deep neuromuscular blockade. However, there are still controversial results as regard sugammadex effects on the quality of recovery. We hypothesized that Sugammadex may have better recovery profile compared to neostigmine in pediatric patients with congenital heart diseases undergoing cardiac catheterization.
This prospective randomized double-blind study included 50 pediatric patients aged <2 years who were divided into two groups according to the reversal agent used; Group S (Sugammadex) and Group N (Neostigmine). Both groups received the same anesthetic technique during cardiac catheterization, and basic hemodynamic monitoring was ensured in both groups. After the procedure, reversal was done using 4 mg.kg sugammadex or 0.04 mg. kg neostigmine plus 0.02 mg. kg atropine according to the group allocation. Recovery time and side effects were recorded.
The two groups showed comparable findings regarding demographics. Nonetheless, the total time of anesthesia had mean values of 91.06 and 101.25 min in the two groups, respectively ( = 0.003), while recovery time had mean values of 1.61 and 9.23 min in the same groups, respectively ( < 0.001). Hemodynamic profile (heart rate and mean arterial pressure) was better after reversal with sugammadex. Blood sugar levels and side effects showed no significant difference between both groups.
Sugammadex can be a more rapid and effective alternative to neostigmine for reversal of rocuronium-induced neuromuscular blockade in pediatric patients undergoing cardiac catheterization.
舒更葡糖钠是一种选择性逆转剂，具有逆转深度神经肌肉阻滞的能力。然而，关于舒更葡糖钠对恢复质量的影响仍存在有争议的结果。我们假设，在接受心导管插入术的先天性心脏病儿科患者中，舒更葡糖钠相比新斯的明可能具有更好的恢复情况。
这项前瞻性随机双盲研究纳入了50名年龄小于2岁的儿科患者，根据所使用的逆转剂分为两组；S组（舒更葡糖钠）和N组（新斯的明）。两组在心导管插入术期间接受相同的麻醉技术，并确保两组都进行基本的血流动力学监测。术后，根据分组分配，使用4mg/kg舒更葡糖钠或0.04mg/kg新斯的明加0.02mg/kg阿托品进行逆转。记录恢复时间和副作用。
两组在人口统计学方面表现出可比的结果。尽管如此，两组的总麻醉时间平均值分别为91.06分钟和101.25分钟（P = 0.003），而相同两组的恢复时间平均值分别为1.61分钟和9.23分钟（P < 0.001）。用舒更葡糖钠逆转后血流动力学情况（心率和平均动脉压）更好。两组之间血糖水平和副作用无显著差异。
对于接受心导管插入术的儿科患者，舒更葡糖钠可作为新斯的明更快速有效的替代品，用于逆转罗库溴铵诱导的神经肌肉阻滞。
