Ozlem Ozmete1, Cagla Bali2, Oya Yalcin Cok3, Hatice Evren Eker Turk4, Nesrın Bozdogan Ozyilkan5, Soner Civi6, Anıs Aribogan7. 1. Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana, Turkey. Electronic address: ozlemyilma@yahoo.com. 2. Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana, Turkey. Electronic address: caglaetike@hotmail.com. 3. Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana, Turkey. Electronic address: oyacok01@yahoo.com. 4. Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana, Turkey. Electronic address: evreneker@yahoo.com. 5. Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana, Turkey. Electronic address: nesrinbozdogan@yahoo.com. 6. Neurosurgery Department, Baskent University School of Medicine, Adana, Turkey. Electronic address: sonercivi@yahoo.com. 7. Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana, Turkey; Neurosurgery Department, Baskent University School of Medicine, Adana, Turkey. Electronic address: aaribogan@yahoo.com.
Abstract
STUDY OBJECTIVE: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. DESIGN: Retrospective observational study. SETTING: University teaching hospital. PATIENTS: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study. INTERVENTIONS: Anesthesia was induced with 5 mg/kg thiopental, 1 μg/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation. METHODS: The neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3mg/kg sugammadex was administered. MEASUREMENTS: The demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded. MAIN RESULTS: Twenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed. CONCLUSIONS: The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium.
STUDY OBJECTIVE: To evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infantpatients. DESIGN: Retrospective observational study. SETTING: University teaching hospital. PATIENTS: Twenty-six infants (2-12 months of age; 3-11 kg) with an American Society of Anesthesiologists classification I, II, or III who were scheduled to undergo neurosurgical procedures were included in the study. INTERVENTIONS: Anesthesia was induced with 5 mg/kg thiopental, 1 μg/kg fentanyl and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation. METHODS: The neuromuscular block was monitored with acceleromyography using train-of-four (TOF) stimuli. Patients received additional doses of rocuronium to maintain a deep block during surgery. If profound neuromuscular block (TOF, 0) persisted at the end of the surgery, 3mg/kg sugammadex was administered. MEASUREMENTS: The demographic data, surgeries, and anesthetic agents were recorded. The time from sugammadex administration to recovery of neuromuscular function (TOF ratio, >0.9) and complications during and after extubation were also recorded. MAIN RESULTS: Twenty-six infants who had a deep neuromuscular block (TOF, 0) at the end of surgery received 3 mg/kg sugammadex. The mean recovery time of the T4/T1 ratio of 0.9 was 112 seconds. No clinical evidence of recurarization or residual curarization was observed. CONCLUSIONS: The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromuscular block induced by rocuronium.