Comparison of reversal and adverse effects of sugammadex and combination of — Anticholinergic-Anticholinesterase agents in pediatric patients

Çi?dem Özgün, Türkay Çakan, Bülent Baltac?, Hülya Ba?ar


Background: We aimed to compare clinical effects of sugammadex versus combination of anticholinergic-anticholinesterase agents for reversing of nondepolarizing neuromuscular block in pediatric patients.Materials and Methods: A total of 60 pediatric patients  whom should be performed general anesthesia in the supine position were enrolled to this randomized double-blinded clinical trial.Fentanyl 1?g/kg, propofol 2 mg/kg, rocuronium 0.6 mg/kg were used in induction and sevofluran, 50% O2-50% N2O in maintenance of anesthesia. Neuromuscular conductions were assessed by train of four (TOF)-Watch SX (Organon, Schering-Plough, Ireland) acceleromyograph. Patients were intubated at the moment of TOF 0. At the end of the operation emergence of T2 point was replied by 2 mg/kg sugammadex administration in group 1 and 0.06 mg/kg neostigmine +0.02 mg/kg atropine in group 2. At the moment of T0.9 inhalation, gases were ceased, and patients were extubated. Hemodynamic alterations, access to T0.9, extubation time, recovery parameters, drug consumptions and adverse effects were recorded. Results:Train of four scores showed a lesser increase  in group 2 than group 1 from 15th s to 30th min during post reverse period (from 6.9 ± 6.4 to 91.7 ± 7.2 in group 2 vs. from 35.4 ± 21.4 to 99.5 ± 1.0 in group 1) (P<0.001). Group 1 patients exhibited much more complete muscle strength rates than group 2 (P< 0.001). T0.9 and extubation times were significantly longer in group 2 than group 1 (P< 0.00). Comparison of adverse effects yielded no difference.Conclusion: Sugammadex can be considered as a safe agent in order to reverse neuromuscular block in pediatric patients

Key words: Atropine, gamma cyclodextrins, neostigmine, neuromuscular nondepolarizing agents

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