Research Information System
JOURNAL OF CLINICAL ANESTHESIA, vol.27, no.1, pp.51-56, 2015 (SCI-Expanded, Scopus)
Study Objective: To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting (PONY) than the cholinesterase inhibitor neostigmine. Design: Prospective, randomized, double-blinded study. Setting: University-affiliated hospital. Patients: One hundred American Society of Anesthesiologists physical status 1 and 2 patients scheduled for extremity surgery. Interventions: Patients were randomly assigned to neostigmine (70 mu g/kg) and atropine (0.4 mg per mg neostigmine) or sugammadex 2 mg/kg for neuromuscular antagonism at the end of anesthesia, when 4 twitches in response to train-of-four stimulation were visible with fade. Measurements: We recorded PONY, recovery parameters, antiemetic consumption, and side effects. Main Results: Nausea and vomiting scores were lower in the sugammadex patients upon arrival in the postanesthesia care unit (med: 0 [min-max, 0-3] vs med: 0 [min-max, 0-3]; P <.05), but thereafter low and comparable. Postoperative antiemetic and analgesic consumption were similar in each group. Extubation (median [interquartile range], 3 [1-3.25] vs 4 [1-3.25]; P <.001) first eye opening (4 [3-7.25] vs 7 [5-11]; P <.001), and head lift (4 [2-7.25] vs 8 [11-25]; P <.001) in minutes were shorter in patients given sugammadex. Postoperative heart rates were significantly lower in all measured times patients given neostigmine. Conclusions: Nondepolarizing neuromuscular blocking antagonism with sugammadex speeds recovery of neuromuscular strength but only slightly and transiently reduces PONY compared with neostigmine and atropine. (C) 2014 Elsevier Inc. All rights reserved.