Ali Hiba Iqbal, Misra Shilpi, Parashar Samiksha, Nagar Kriti, Das Praveen Kumar
Department of Anaesthesiology, Dr. RMLIMS, Lucknow, Uttar Pradesh, India.
Int J Crit Illn Inj Sci. 2025 Apr-Jun;15(2):51-56. doi: 10.4103/ijciis.ijciis_25_25. Epub 2025 Jun 23.
Rapid and complete reversal of neuromuscular blockade (NMB) allows for the adequate return of respiration and motor function, thereby expediting recovery and preventing micro-aspirations postoperatively. Diaphragmatic ultrasonography (DUS) is an easy, noninvasive and reliable diagnostic tool to quantify and assess respiratory function and exclude any postoperative residual curarization (PORC). Sugammadex, a modified gamma cyclodextrin reverses NMB faster and more reliably from a deep or profound blockade. We aimed to evaluate the efficacy of Sugammadex for the reversal of NMB in patients undergoing major upper abdominal surgery and to determine the risk of PORC using DUS.
The present prospective, observational study included patients aged 18-65 years undergoing major upper abdominal surgery. The participants of Group A received Sugammadex and Group B received Neostigmine-Glycopyrrolate as reversal agent. Time of extubation and diaphragmatic thickness was noted at base line, 10 min-30 min postextubation. The statistical analysis was done using SPSS (Statistical Package for the Social Sciences) Version 21.0.
The time required to extubate was significantly shorter in Group A as compared to Group B (81.96 ± 37.30 s vs. 204.20 ± 99.91 s, < 0.001). The diaphragm thickness at 10 min after extubation was higher in Group A compared to Group B (0.42 ± 0.04 cm vs. 0.4 ± 0.04 cm, = 0.043).
Sugammadex is more effective in achieving rapid reversal of NMB compared to neostigmine. The use of diaphragm ultrasonography provides valuable insights into respiratory function and the risk of PORC postoperatively.
神经肌肉阻滞（NMB）的快速、完全逆转可使呼吸和运动功能充分恢复，从而加速康复并预防术后微量误吸。膈肌超声检查（DUS）是一种简单、无创且可靠的诊断工具，可用于量化和评估呼吸功能，并排除任何术后残余肌松（PORC）。舒更葡糖钠是一种改良的γ-环糊精，能更快、更可靠地逆转深度或极深阻滞状态下的NMB。我们旨在评估舒更葡糖钠在接受上腹部大手术患者中逆转NMB的疗效，并使用DUS确定PORC的风险。
本前瞻性观察性研究纳入了年龄在18至65岁之间、接受上腹部大手术的患者。A组参与者接受舒更葡糖钠，B组接受新斯的明-格隆溴铵作为逆转剂。在基线、拔管后10分钟至30分钟记录拔管时间和膈肌厚度。使用SPSS（社会科学统计软件包）21.0版进行统计分析。
与B组相比，A组的拔管所需时间显著更短（81.96±37.30秒对204.20±99.91秒，<0.001）。拔管后10分钟时，A组的膈肌厚度高于B组（0.42±0.04厘米对0.4±0.04厘米，=0.043）。
与新斯的明相比，舒更葡糖钠在实现NMB的快速逆转方面更有效。膈肌超声检查的应用为术后呼吸功能和PORC风险提供了有价值的见解。
