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Journals / Osmangazi Tıp Dergisi / 2019 / Cilt: 41 Sayı: 4

Comparison of Neostigmin Versus Sugammadex in Reversal of Neuromuscular Blockade after Abdominal Surgery of Obese Patients Whose Bmi ≥30

Batın Cerrahisi Uygulanan BMI≥30 Üzerinde Olan Obez Hastalarda Nöromuskuler Bloğun Geri Döndürülmesinde Neostigmin ve Sugammadeksin Karşılaştırılması

Meryem Onay(bingöl devlet hastanesi)0000-0002-5028-9135
Yılmaz Şentürk(ESKİŞEHİR OSMANGAZİ ÜNİVERSİTESİ, TIP FAKÜLTESİ)
Pages
344–352
Publication Date
2019-10-01
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Sugammadex is superior than neostigmine especially in obese critical patients in terms of effective faster and safer airway management.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Our aim is to compare neostigmin versus sugammadex in reversal of neuromuscular blockade of vecuronium after abdominal surgery of obese patients whose BMI ≥30.
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Key Findings & Data:This study is performed on 70 patients whose BMI ≥30 and ASA I-II-III.
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Conclusion & Impact:Sugammadex is superior than neostigmine especially in obese critical patients in terms of effective faster and safer airway management.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:sugammadeks · neostigmine · obezite

Abstract

Our aim is to compare neostigmin versus sugammadex in reversal of neuromuscular blockade of vecuronium after abdominal surgery of obese patients whose BMI ≥30. This study is performed on 70 patients whose BMI ≥30 and ASA I-II-III. They are 18-65 years old and scheduled for any abdominal surgery under general anesthesia. They are monitorized with TOF-watch for neuromuscular blockade and standard non-invasive monitorization. Vecuronium 0,1 mg/kg is given during anesthesia induction. According to type of surgery, extra doses of vecuronium 0.01-0.02 mg/kg is added to keep TOF between 0-2. During recovery period, when TOF number exceeds 2 and diaphragmatic movements begin, group sug received sugammadex 2 mg/kg and group neo received neostigmin 0,05 mg/kg with atropine 0,02 mg/kg. When TOF ratio becomes 0,9 and clinical evaluation is completed, patient is extubed. Group sug and neo recovery durations from TOF2 to TOF 0.9 are respectively 3,7 minutes and 14 minutes. (p<0,001) Demographic data revealed no significant difference between Group sug and group neo except BMI and surgery type (p=0,017 , p=0,008 ). PORC(Postoperative residual curarization) is a predicted complication in obesity. Sugammadex is superior than neostigmine especially in obese critical patients in terms of effective faster and safer airway management.

Özet

Bu ç alışmadaki amacımız BMI≥30 üzerindeki obez hastalarda , batın cerrahisi operasyonlarında, vekuronyum ile sağlanan n ö romüskü ler blog ̆un geri d ö ndürülmesinde neostigmin ve sugammadeksin etkinliğinin karşılaştırılmasıdır. Bu ç alışma genel anestezi altında, batın cerrahisi planlanan, ASA I-II-III olan, 18-65 yaş arası, BMI≥30 üzerindeki 70 hastada yapıldı. Noninvaziv monitorizasyonla birlikte n ö romuskuler monitorizasyon i ç in TOF - Watch uygulandı. Anestezi indüksiyonunda kas gevşetici olarak vekuronyum 0.1 mg/kg uygulandı, cerrahinin türü ne g ö re TOF 0-2 arasında olacak şekilde 0.01 -0.02 (mg/kg) vekuronyum ile ek doz uygulandı. Derlenme d ö neminde TOF sayısının 2 nin üzerinde ve klinik olarak diyafram haraketlerinin başladıktan sonra n ö romuskuler bloğun geri d ö ndürülmesinde sugammadeks (grup sug) 2mg/kg ve neostigmin (grup neo) 0.05mg/kg ile birlikte atropin 0.02mg/kg uygulandı . TOF oranı 0.9 olduğunda ve hastanın klinik değerlendirilmesi sonucu extübe edildi. Grup sug ve neo hastalarda T2’den TOF oranı 0.9’a ulaş ma s üresi sırasıyla 3,7 dk ve 14 dk idi (p<0,001). Demografik verilerde Grup sug ve grup neo arasında BMI ve ameliyat türü dışında anlamlı fark bulunmadı (p=0,017 , p=0,008 ). PORC obezitede ö ng ö rülebilir bir komplikasyondur. Sugammadeks, neostigmine g ö re obezite gibi kritik hastalarda daha hızlı ve güvenli hava yolu sağlamada etkin bir ajan olduğunu düşünmekteyiz.

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Cite This Article

Onay, M., Şentürk, Y. (2019). Comparison of Neostigmin Versus Sugammadex in Reversal of Neuromuscular Blockade after Abdominal Surgery of Obese Patients Whose Bmi ≥30. Osmangazi Tıp Dergisi, Cilt: 41 Sayı: 4, 344–352. https://doi.org/10.20515/otd.427647

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