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001-es BibID:BIBFORM070620
Első szerző:Asztalos László (aneszteziológus)
Cím:Reversal of Vecuronium-induced Neuromuscular Blockade with Low-dose Sugammadex at Train-of-four Count of Four : a Randomized Controlled Trial / László Asztalos, Zoltán Szabó-Maák, András Gajdos, Réka Nemes, Adrienn Pongrácz, Szabolcs Lengyel, Béla Fülesdi, Edömér Tassonyi
Dátum:2017
Megjegyzések:Background: Rocuronium-induced neuromuscular block that spontaneously recovered to a train-of-four count of four can bereversed with sugammadex 0.5 or 1.0 mg/kg. We investigated whether these doses of sugammadex can also reverse vecuroniumat a similar level of block.Methods: Sixty-five patients were randomly assigned, and 64 were analyzed in this controlled, superiority study. Participantsreceived general anesthesia with propofol, sevoflurane, fentanyl, and vecuronium. Measurement of neuromuscular functionwas performed with acceleromyography (TOF-Watch-SX, Organon Teknika B.V., The Netherlands ). Once the block recoveredspontaneously to four twitches in response to train-of-four stimulation, patients were randomly assigned to receivesugammadex 0.5, 1.0, or 2.0 mg/kg; neostigmine 0.05 mg/kg; or placebo. Time from study drug injection to normalizedtrain-of-four ratio 0.9 and the incidence of incomplete reversal within 30 min were the primary outcome variables. Secondaryoutcome was the incidence of reparalysis (normalized train-of-four ratio less than 0.9).Results: Sugammadex, in doses of 1.0 and 2.0 mg/kg, reversed a threshold train-of-four count of four to normalized train-offourratio of 0.9 or higher in all patients in 4.4 ? 2.3 min (mean ? SD) and 2.6 ? 1.6 min, respectively. Sugammadex 0.5 mg/kgreversed the block in 6.8 ? 4.1 min in 70% of patients (P < 0.0001 vs. 1.0 and 2.0 mg/kg), whereas neostigmine producedreversal in 11.3 ? 9.7 min in 77% of patients (P > 0.05 vs. sugammadex 0.5 mg/kg). The overall frequency of reparalysis was18.7%, but this incidence varied from group to group.Conclusions: Sugammadex 1.0 mg/kg, unlike 0.5 mg/kg, properly reversed a threshold train-of-four count of four vecuroniuminducedblock but did not prevent reparalysis.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
neuromuscular block
Megjelenés:Anesthesiology. - 127 : 3 (2017), p. 441-449. -
További szerzők:Szabó-Maák Zoltán (1984-) (aneszteziológus, intenzív terápiás szakorvos) Gajdos András Nemes Réka (1985-) (aneszteziológus, intenzív terápiás szakorvos) Pongrácz Adrienn (1971-) (aneszteziológus, intenzív terápiás szakorvos) Lengyel Szabolcs (1971-) (biológus) Fülesdi Béla (1961-) (aneszteziológus) Tassonyi Edömér (1940-2022) (aneszteziológus)
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