Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study
Reversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study
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DOI：
10.1111/aas.12155
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发表时间：
2013-10-01
影响因子：
2.1
通讯作者：
Di Marco, P.
中科院分区：
文献类型：
--
作者：
Della Rocca, G.;Pompei, L.;Di Marco, P.
背景这项“真实”研究旨在分析接受罗库溴铵治疗的患者从开始使用新斯的明或sugammadex到恢复到四联比（TOFr）0.9的时间。次要目的是评估患者的比例：呈现TOFr < 0.9后5，10，20分钟从逆转剂给药，接受阿片类药物用于术中镇痛和拔管在麻醉后监护室（PACU）methodsThis是一个多站点，前瞻性，非随机，观察现实生活中的研究。在T-2重现或强直后计数为1或2时给予恢复剂。药物剂量是免费的，根据每个研究者的通常practice.ResultsThree一百五十九例患者参加了这项研究。sugammadex组从逆转给药到TOFr降至0.9的时间明显快于新斯的明组（浅阻滞：2.2 vs. 6.9 min; P < 0.0001;深阻滞：2.7 vs. 16.2 min; P < 0.0001）。新斯的明组在逆转剂给药后5、10和20 min时TOFr < 0.9的患者数量高于sugammadex组。只有5名患者没有接受阿片类药物。除sugammadex组1例患者在PACU后拔管外，所有患者均在手术室拔管。结论该真实研究证实sugammadex组患者的逆转时间比新斯的明组更快。逆转后20分钟TOFr < 0.9仅见于新斯的明治疗的患者。
BackgroundThis 'real-life' study aimed to analyze the time from the start of neostigmine or sugammadex administration to recovery to a train of four ratio (TOFr) of 0.9 in a real-life in patients receiving rocuronium. The secondary aims were to assess the proportion of patients: presenting TOFr < 0.9 after 5, 10, and 20 min from reversal agent administration, receiving opioids for intraoperative analgesia and extubated in the post-anesthesia care unit (PACU).MethodsThis was a multisite, prospective, nonrandomized, observational real-life study. Reversal agent was administered at either T-2 reappearance or at a post-tetanic count of 1 or 2. Drugs dosages were free according to each investigator's usual practice.ResultsThree hundred fifty-nine patients were enrolled onto the study. Time from reversal administration to TOFr to 0.9 is significantly faster in the sugammadex group than in the neostigmine group (shallow block: 2.2 vs. 6.9 min, respectively; P < 0.0001; deep block: 2.7 vs. 16.2 min, respectively; P < 0.0001). The number of patients with TOFr < 0.9 at 5, 10, and 20 min post-reversal agent administration was higher in the neostigmine than in the sugammadex group. Just five patients did not receive opioids. All patients were extubated in the operative room except for a single patient in the sugammadex group who was extubated following PACU admission.ConclusionsThis real-life study confirms that reversal time is faster in patients receiving sugammadex than in those receiving neostigmine. TOFr < 0.9 20 min after reversal was only present in patients treated with neostigmine.