Chang Hsiao-Cheng, Liu Shih-Yuan, Lee Min-Jia, Lee Sing-Ong, Wong Chih-Shung
Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.
School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan.
J Formos Med Assoc. 2022 Dec;121(12):2639-2643. doi: 10.1016/j.jfma.2022.04.017. Epub 2022 May 13.
Sugammadex is a direct reversal agent of aminosteroid muscle relaxants, particularly rocuronium, with promptly and completely reverse of deep neuromuscular block (NMB), which allows better surgical conditions. Sugammadex exhibits advantages over indirect reversal agent acetylcholinesterase inhibitor neostigmine with less adverse effects. In this retrospective review, we compared the incidence of postoperative vomiting (POV), postoperative urinary retention (POUR), and hemodynamic changes between sugammadex and neostigmine/glycopyrrolate in reversal of muscular blockade. Sugammadex showed superior in all three aspects. The heart rate was 7.253 lower (P < 0.0001) and mean arterial pressure was 5.213 lower (P < 0.0001) in sugammadex group. The POV of neostigmine/glycopyrrolate group was 3.16 times more than sugammadex group (OR = 3.16, p < 0.0001), and POUR of neostigmine/glycopyrrolate group was 4.291 times more than sugammadex group (OR = 4.291, p < 0.0001). Sugammadex showed better hemodynamic stability, and lower incidence of POV and POUR than neostigmine/glycopyrrolate.
舒更葡糖钠是一种氨基甾体类肌肉松弛剂的直接逆转剂，尤其对罗库溴铵有效，能迅速且完全地逆转深度神经肌肉阻滞（NMB），从而改善手术条件。与间接逆转剂乙酰胆碱酯酶抑制剂新斯的明相比，舒更葡糖钠具有不良反应更少的优势。在这项回顾性研究中，我们比较了舒更葡糖钠与新斯的明/格隆溴铵在逆转肌肉阻滞时术后呕吐（POV）、术后尿潴留（POUR）的发生率以及血流动力学变化。舒更葡糖钠在这三个方面均表现更优。舒更葡糖钠组的心率降低了7.253（P < 0.0001），平均动脉压降低了5.213（P < 0.0001）。新斯的明/格隆溴铵组的POV是舒更葡糖钠组的3.16倍（OR = 3.16，p < 0.0001），新斯的明/格隆溴铵组的POUR是舒更葡糖钠组的4.291倍（OR = 4.291，p < 0.0001）。与新斯的明/格隆溴铵相比，舒更葡糖钠表现出更好的血流动力学稳定性，且POV和POUR的发生率更低。
