Cerebral Oxygenation and Metabolism after Reversal of Rocuronium: Comparison between Sugammadex versus Neostigmine | ||
| The Egyptian Journal of Hospital Medicine | ||
| Article 6, Volume 89, Issue 1, October 2022, Pages 4176-4186 PDF (967.76 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2022.256319 | ||
| Authors | ||
| tamer Farahat* ; Sherif Abdo Mousa | ||
| Anesthesia and Intensive Care and pain managment department faculty of medicine Mansoura University | ||
| Abstract | ||
| Background: Recovery from neuroanesthesia requires stable hemodynamics and optimal cerebral oxygenation. Objective: The purpose of this study was to compare the effect of low dose sugammadex with neostigmine on recovery and cerebral hemodynamic profile after supratentorial tumor resection. Patients and Methods: In this double-blind randomized study, forty patients were allocated according to the reversal used after supratentorial tumor surgery into, sugammadex 2 mg·kg–1 (group S) or neostigmine 0.05 mg·kg–1 + atropine 0.02 mg·kg–1 (group N). Duration from reversal to train of four 0.9 was a primary outcome. Arterial and jugular bulb blood samples obtained after induction, before closure of dura, before reversal, ten minutes after reversal then one hourly for 3 hours postoperative for the calculation of arterial-jugular oxygen content difference “CaO2-jO2,” cerebral oxygen extraction “CEO2”, jugular venous oxygen saturation (SjvO2), estimated cerebral metabolic rate “eCMRO2,” and cerebral blood flow equivalent “CBFe,” as secondary outcomes. Results: We demonstrated that recovery time (duration from reversal to train of four 0.9) was significantly shorter with sugammadex (P=0.001). Sugammadex recorded significant increased CEO2 and CaO2-jO2 at 10 minutes after reversal, at 1 hour (hr), 2 hr and 3 hr postoperatively. Sugammadex resulted in significant decreased SjvO2 and CBFe at 10 minutes after reversal, at 1 hr, 2 hr and 3 hr postoperatively without significant effect on eCMRO2. Conclusion: Low dose sugammadex (2 mg.kg-1) provided rapid and effective reversal of rocuronium NMB superior to neostigmine with improved cerebral hemodynamic profile after supratentorial tumor surgery. | ||
| Keywords | ||
| Cerebral hemodynamic; Neostigmine; Sugammadex; Supratentorial tumor | ||
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