Akademik Veri Yönetim Sistemi
Journal of Clinical Anesthesia, cilt.27, sa.1, ss.51-56, 2015 (SCI-Expanded)
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. 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 PONV compared with neostigmine and atropine.