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001-es BibID:BIBFORM060544
Első szerző:Tassonyi Edömér (aneszteziológus)
Cím:Reversal of Pipecuronium-Induced Moderate Neuromuscular Block with Sugammadex in the Presence of a Sevoflurane Anesthetic / Edömér Tassonyi, Adrienn Pongrácz, Réka Nemes, László Asztalos, Szabolcs Lengyel, Béla Fülesdi
Dátum:2015
ISSN:0003-2999
Megjegyzések:BACKGROUND:Pipecuronium is a steroidal neuromuscular blocking agent. Sugammadex, a relaxant binding ?-cyclodextrin derivative, reverses the effect of rocuronium, vecuronium, and pancuronium. We investigated whether sugammadex reverses moderate pipecuronium-induced neuromuscular blockade (NMB) and the doses required to achieve reversal.METHODS:This single-center, randomized, double-blind, 5-group parallel-arm study comprised 50 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and pipecuronium. Neuromuscular monitoring was performed with acceleromyography (TOF-Watch SX) according to international standards. When the NMB recovered spontaneously to train-of-four count 2, patients randomly received 1.0, 2.0, 3.0, or 4.0 mg/kg of sugammadex or placebo. Recovery time from sugammadex injection to normalized train-of-four (TOF) ratio 0.9 was the primary outcome variable. The recovery time from the sugammadex injection to final T1 was the secondary end point. Postoperative neuromuscular functions were also assessed.RESULTS:Each patient who received sugammadex recovered to a normalized TOF ratio of 0.9 within 5.0 minutes (95% lower confidence interval for the lowest dose 70.1%; for all doses 90.8%) and 79% of these patients reached a normalized TOF ratio 0.9 within 2.0 minutes (95% lower confidence interval for the lowest dose 26.7%; for all doses 63.7%). T1 recovered several minutes after the TOF ratio. No residual postoperative NMB was observed.CONCLUSIONS:Sugammadex adequately and rapidly reverses pipecuronium-induced moderate NMB during sevoflurane anesthesia. Once the train-of-four count has spontaneously returned to 2 responses following pipecuronium administration, a dose of 2.0 mg/kg of sugammadex is sufficient to reverse the NMB.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Anesthesia And Analgesia. - 121 : 2 (2015), p. 373-380. -
További szerzők:Pongrácz Adrienn (1971-) (aneszteziológus, intenzív terápiás szakorvos) Nemes Réka (1985-) (aneszteziológus, intenzív terápiás szakorvos) Asztalos László (1985-) (aneszteziológus) Lengyel Szabolcs (1971-) (biológus) Fülesdi Béla (1961-) (aneszteziológus)
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