Sugammadex Compared With Neostigmin/Atropin for Neuromuscular Block Reversal in Patients With Obstructive Sleep Apnea
Study Details
Study Description
Brief Summary
Incomplete recovery of neuromuscular function after surgery can lead to respiratory complications. Patients with obstructive sleep apnea (OSA) are prone to respiratory complications after surgery. Neostigmin and sugammadex are used for neuromuscular reversal.
The aim of this study was to compare sugammadex and neostigmin regarding efficacy, incidence of respiratory complications and cost in patients undergoing surgery for OSA
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
| Phase 4 |
Detailed Description
This prospective double blind controlled study will be conducted after obtaining informed written patient consent.
Simple randomization will be accomplished with a computer-generated sequence of numbers and sealed envelopes will be used to allocate patients into 2 groups.
Group N will receive 50 µg kg-1 neostigmin,+05 mg atropin Group S will receive sugammadex 2mg kg-1 sugammadex at the and of surgery. Patients will enter the operation room without receiving premedication Heart rate, noninvasive blood pressures, body temperature, BIS, end-tidal respiratory gases and neuromuscular function (acceleromyography) will be monitored Propofol will be used for anesthesia induction Rocuronium 0.6 mg kg-1 will be used to facilitate intubation Anesthesia will be maintained with sevoflurane in oxygen and nitrous oxide, BIS will be maintainen between 40-60 Additional rocuronium doses will be administered when the TOF T2 is observed At the end of surgery, volatile anesthesia will be discontinued, the study drug will be administered according to group allocation and the TOF response at this time will be recorded Time to obtain TOF0.9 will be recorded Time to extubation, time to recovery, time spent in the operation room will be recorded Respiratory and cardiovascular complications (bradycardia, tachycardia, hypertention, ritmia, bronchospasm, laringospasm, breath holding, cough, desaturation, hypoxia, NIMV, reintubation) and treatments during anesthesia emergence will be recorded Patients will be transfered to the PACU, time spent in PACU and respiratory and cardiovascular complications (bradycardia, tachycardia, hypertention, ritmia, bronchospasm, laringospasm, breath holding, cough, desaturation, hypoxia, NIMV, reintubation) and treatments during PACU stay will be recorded After achieving an Aldrete score >9 patients will be transfered to the ward. Patients who can not achieve Aldrete score >9 after 1 hour will be transfered to the ICU.
Respiratory and cardiovascular complications and treatments in the ICU will be recored
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Sugammadex Group S patients will receive 2 mg kg -1 sugammadex at the end of surgery |
Drug: Sugammadex
Group S patients will receive 2 mg kg -1 sugammadex at he end of surgery
|
| Active Comparator: Neostigmine Group N patients will receive 50 µg kg-1 neostigmine and 05 mg atropin at the end of surgery |
Drug: Neostigmine
Patient in Gropu N will receive 50 µg kg-1 neostigmin and 05 mg atropin at the end of surgery
|
Outcome Measures
Primary Outcome Measures
- TOF0.9 time [postoperative 5 minutes]
TOF 0.9 time will be recorded form the TOF watch after the study drug administration
Secondary Outcome Measures
- desaturation [postoperative 5 minutes]
patients will be monitored for desaturation after extubation
- bradycardia [postoperative 5 minutes]
heart rate will bw monitored after extubation
- tachycardia [postoperative 5 minutes]
heart rate will be monitored after extubation
Other Outcome Measures
- operation room time [postoperative 30 minutes]
the time elapsed from the study drug administration to the the time the patient was transfered to the PACU
- PACU time [poastoperative 1 hour]
time elapsed from the the patient entering the PACU to the time the patient left the PACU
Eligibility Criteria
Criteria
Inclusion Criteria:
ASA I-III Schedulled for surgery for obstructive sleep apnea -
Exclusion Criteria:
Neurouscular disorders hepatic or renal dysfunction allergy to study drugs using medication that could interfere with NMBAs pregnancy breasth feeding
-
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Diskapi Yildirim Beyazit Teaching and Research Hospital | Ankara | Turkey |
Sponsors and Collaborators
- Diskapi Teaching and Research Hospital
Investigators
- Principal Investigator: Dilek yazicioglu, Dr, Dişkapı yildirim beyazit Teaching and Research Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Jones RK, Caldwell JE, Brull SJ, Soto RG. Reversal of profound rocuronium-induced blockade with sugammadex: a randomized comparison with neostigmine. Anesthesiology. 2008 Nov;109(5):816-24. doi: 10.1097/ALN.0b013e31818a3fee.
- Kaw R, Pasupuleti V, Walker E, Ramaswamy A, Foldvary-Schafer N. Postoperative complications in patients with obstructive sleep apnea. Chest. 2012 Feb;141(2):436-441. doi: 10.1378/chest.11-0283. Epub 2011 Aug 25.
- Khuenl-Brady KS, Wattwil M, Vanacker BF, Lora-Tamayo JI, Rietbergen H, Alvarez-Gómez JA. Sugammadex provides faster reversal of vecuronium-induced neuromuscular blockade compared with neostigmine: a multicenter, randomized, controlled trial. Anesth Analg. 2010 Jan 1;110(1):64-73. doi: 10.1213/ane.0b013e3181ac53c3. Epub 2009 Aug 27.
- Sugammadex-OSA