Ge Qian, Shao Lin, Wen Chao, Zhao Shiling
Department of Anesthesiology, The Third People's Hospital of Dalian, Dalian, Liaoning, China.
Department of Anesthesiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Medicine (Baltimore). 2025 May 16;104(20):e42385. doi: 10.1097/MD.0000000000042385.
Sugammadex sodium can antagonize aminosteroidal muscarinic drugs precisely and rapidly, so it has been widely used in fast-track anesthesia in recent years. However, it is not known whether there is an advantage of the antagonistic effect of sugammadex sodium over neostigmine at different doses and time points. In this single-center, randomized controlled study, we compared the effects of sugammadex sodium with neostigmine on postoperative myorelaxation recovery in patients undergoing suspension laryngoscopic surgery.
A total of 90 patients scheduled for elective general anesthesia suspension laryngoscopy were selected, aged 18 to 65 years, body mass index 18 to 28 kg/m², and American Society of Anesthesiologists I-II grade. Patients were randomly divided into 3 groups: the sugammadex group (experimental groups, S1, S2), and the neostigmine group (control group, N), each comprising 30 patients. After the operation, group S1 received an intravenous injection of sugammadex sodium 2 mg/kg immediately, S2 received it when train-of-four COUNT (TOF-COUNT) > 2, and group N received intravenous injections of atropine 0.02 mg/kg + neostigmine 0.04 mg/kg when TOF-COUNT > 2. The mean arterial pressure, heart rate, pulse oxygen saturation, and bispectral index were recorded at various times: upon room entry (T1), during tracheal intubation (T2), at surgery start (T3), surgery end (T4), at extubation (T5), and upon room exit (T6). The duration of surgery, muscle relaxation recovery time from TOF-COUNT 0-2 at surgery end, and time from surgery end to extubation were recorded for each group, as well as the incidence of adverse reactions.
There were no statistically significant differences among the 3 groups in mean arterial pressure, heart rate, pulse oxygen saturation, and bispectral index at the 6 time points (T1, T2, T3, T4, T5, and T6). In terms of extubation timing, the S1 group showed a significantly shorter time compared with the S2 and N groups (P < .05). Compared with the S2 group, N group had significantly prolonged extubation times, showing a statistical difference. Compared with the N group, S1 and S2 groups had a significantly reduced incidence of bradycardia and increased secretions (P < .05).
The use of sugammadex sodium in otolaryngological suspension laryngoscopy surgeries offers certain advantages over neostigmine in terms of muscle relaxation recovery. Administering sugammadex sodium 2 mg/kg directly after surgery as compared with waiting until TOF-COUNT > 2 allows for earlier removal of the tracheal tube without increasing adverse reactions.
舒更葡糖钠能精确、快速地拮抗甾体类肌松药，近年来已广泛应用于快通道麻醉。然而，不同剂量和时间点下舒更葡糖钠的拮抗作用是否优于新斯的明尚不清楚。在这项单中心随机对照研究中，我们比较了舒更葡糖钠和新斯的明对行支撑喉镜手术患者术后肌松恢复的影响。
选取90例行择期全身麻醉支撑喉镜检查的患者，年龄18至65岁，体重指数18至28kg/m²，美国麻醉医师协会分级I-II级。患者随机分为3组：舒更葡糖钠组（实验组，S1、S2）和新斯的明组（对照组，N），每组30例。术后，S1组立即静脉注射舒更葡糖钠2mg/kg，S2组在四个成串刺激计数（TOF计数）>2时注射，N组在TOF计数>2时静脉注射阿托品0.02mg/kg + 新斯的明0.04mg/kg。在不同时间点记录平均动脉压、心率、脉搏血氧饱和度和脑电双频指数：入室时（T1）、气管插管期间（T2）、手术开始时（T3）、手术结束时（T4）、拔管时（T5）和出室时（T6）。记录每组的手术时长、手术结束时从TOF计数0至2的肌肉松弛恢复时间、手术结束至拔管的时间以及不良反应发生率。
3组在6个时间点（T1、T2、T3、T4、T5和T6）的平均动脉压、心率、脉搏血氧饱和度和脑电双频指数差异均无统计学意义。在拔管时机方面，S1组与S2组和N组相比时间显著更短（P < 0.05）。与S2组相比，N组拔管时间显著延长，差异有统计学意义。与N组相比，S1组和S2组心动过缓和分泌物增多的发生率显著降低（P < 0.05）。
在支撑喉镜手术中，使用舒更葡糖钠在肌肉松弛恢复方面比新斯的明具有一定优势。与等待至TOF计数>2相比，术后直接静脉注射2mg/kg舒更葡糖钠可更早拔除气管导管且不增加不良反应。
