Comparison of sugammadex and conventional reversal on postoperative nausea and vomiting: a randomized, blinded trial.
J Clin Anesth
; 27(1): 51-6, 2015 Feb.
Article
em En
| MEDLINE
| ID: mdl-25544263
ABSTRACT
STUDY OBJECTIVE:
To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting (PONV) 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 µg/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 PONV, recovery parameters, antiemetic consumption, and side effects. MAINRESULTS:
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 PONV compared with neostigmine and atropine.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atropina
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Náusea e Vômito Pós-Operatórios
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Gama-Ciclodextrinas
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Neostigmina
Tipo de estudo:
Clinical_trials
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Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Clin Anesth
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article