ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Surgical Oncology: Neuromuscular Blockade Reversal as a Component of Early Postoperative Rehabilitation

Bibliography link: Khoronenko V. E., Baskakov D. S., Ryabov A. B., MalanovaA. S., Pikin O. V., Suvorin P. A. Surgical Oncology: Neuromuscular Blockade Reversal as a Component of Early Postoperative Rehabilitation. Doctor.Ru. 2017; 6(135): 19–25.

Study Objective: To assess the efficacy and safety of neostigmine methylsulfate and sugammadex for neuromuscular blockade (NMB) reversal as part of early multimodal postoperative rehabilitation.

Study Design: This was a prospective randomized study.

Materials and Methods: Open lobectomy with bronchial reconstruction or pneumonectomy was performed under combined epidural/general anesthesia in a group of cancer patients (n = 100; mean age 57 ± 8.5). Muscle relaxation (TOF 1–2) was achieved using rocuronium bromide. Patients were randomized into two groups. After surgery patients were given either neostigmine methylsulfate 50 µg/kg and atropine sulfate 10 µg/kg (group N, n = 50) or sugammadex 2 mg/kg (group S, n = 50). The efficacy of reversal was assessed by TOF monitoring.

Study Results: In group S NMB reversal (TOF > 90%) was achieved earlier than in group N (2.6 ± 1.2 vs. 9.5 ± 12.9 min, respectively, р < 0.05). After surgery patients in group S stayed in the operating room for shorter periods than patients in group N (9.2 ± 4.3 vs. 14.2 ± 11.4 min, respectively, р < 0.05). There were no differences in the frequency of severe postoperative complications, but postoperative nausea and vomiting were observed significantly more often in group N.

Conclusion: Compared to neostigmine methylsulfate, sugammadex is more effective and its effects are more predictable in reversing NMB caused by steroid muscle relaxants. Moreover, its use is not associated with any significant side effects.

V. E. Khoronenko — P. A. Herzen Moscow Oncology Research Institute, a branch of the National Medical Research Center for Radiology (a Federal Government-Funded Institution), Russian Ministry of Health. E-mail: khoronenko_mnioi@mail.ru

D. S. Baskakov — P. A. Herzen Moscow Oncology Research Institute, a branch of the National Medical Research Center for Radiology (a Federal Government-Funded Institution), Russian Ministry of Health. E-mail: Danil_Bask@mail.ru

A. B. Ryabov — P. A. Herzen Moscow Oncology Research Institute, a branch of the National Medical Research Center for Radiology (a Federal Government-Funded Institution), Russian Ministry of Health. E-mail: khoronenko_mnioi@mail.ru

A. S. Malanova — P. A. Herzen Moscow Oncology Research Institute, a branch of the National Medical Research Center for Radiology (a Federal Government-Funded Institution), Russian Ministry of Health. E-mail: khoronenko_mnioi@mail.ru

O. V. Pikin — P. A. Herzen Moscow Oncology Research Institute, a branch of the National Medical Research Center for Radiology (a Federal Government-Funded Institution), Russian Ministry of Health. E-mail: khoronenko_mnioi@mail.ru

P. A. Suvorin — P. A. Herzen Moscow Oncology Research Institute, a branch of the National Medical Research Center for Radiology (a Federal Government-Funded Institution), Russian Ministry of Health. E-mail: khoronenko_mnioi@mail.ru

Доктор.ру
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