A Comparision of the Effect of Sugammadex on the Recovery Period and Postoperative Residual Block in Young Elderly and Middle-Aged Elderly Patients

A Comparision of the Effect of Sugammadex on the Recovery Period and Postoperative Residual Block in Young Elderly and Middle-Aged Elderly Patients

Background: The importance of the characteristics of anesthesia and postoperative residual curarization (PORC) in the elderly population should be a growing concern in this century. Aims: To investigate the effect of sugammadex on the duration of the recovery from neuromuscular blocking agents and postoperative residual curarization in the young elderly and middle-aged elderly patients who underwent elective laparoscopic cholecystectomy, followed by a train of four (TOF) watch monitorization. Study Design: Prospective clinical trial study. Methods: Sixty patients over the age of 65 with American Society of Anesthesiologists I-III were divided into two groups according to their age (65-74 years old and >=75 years old). Patients received sugammadex (2.0 mg/ kg iv) at the reappearance of the second twitch of the TOF as an agent for reversal of neuromuscular blockage at the end of surgery. Patients were extubated at the time of TOF >=0.9. The patients' TOF responses were evaluated with regards to PORC in at the 5th minute and were followed up for one hour in the recovery room. Reintubation was applied for those patients who developed PORC and had peripheric oxygen saturation =75 years compared to patients aged between 65-74 years. (ClinicalTrials.gov Identifier: ACTRN12615000758505)

___

  • Beğer T, Yavuzer H. Epidemiology of ageing and elderly. J Geriatr 2012;25:13.
  • Xiaobo F, Jianjuan K, Yanlin W. Comparison of the variability of the onset and recovery from neuromuscular blockade with cisatracurium versus rocuronium in elderly patients under total intravenous anesthesia. Braz J Med Biol Res 2012;45:676-80. [CrossRef]
  • Arain SR, Kern S, Ficke DJ, Ebert TJ. Variability of duration of action of neuromuscular-blocking drugs in elderly patients. Acta Anaesthesiol Scand 2005;49:312-5. [CrossRef]
  • McGrath CD, Hunter JM. Monitoring of neuromuscular block. Contin Educ Anaesth Crit Care Pain 2006;6:7-12. [CrossRef]
  • Naguib M, Kopman AF, Ensor JE. Neuromuscular monitoring and postoperative residual curarisation: a meta-analysis. Br J Anaesth 2007;98:302-16. [CrossRef]
  • Onur O. Post-anesthesia recovery and problems. Basic An- aesthesia. Kecik Y (Ed). Gunes Medical Book Stores Co. Ltd. 2012.784-96.
  • Hayes AH, Mirakhur RK, Breslin DS, Reid JE, McCourt KC. Postoperative residual block after intermediate-acting neuromus- cular blocking drugs. Anaesthesia 2001;56:312-8. [CrossRef]
  • Matteo RS, Ornstein E, Schwartz AE, Ostapkovich N, Stone JG. Pharmacokinetics and pharmacodynamics of rocuronium (Org 9426) in elderly surgical patients. Anesth Analg 1993;77:1193-7. [CrossRef]
  • Ozturk L, Izdes S. The safe use of anesthetics and neuromus- cular and neuromuscular blockade reversal drugs in geriat- ric patients. Turkiye Klinikleri J Anest Reanim-Special Topics 2011;4:25-34.
  • Suzuki T, Kitajima O, Ueda K, Kondo Y, Kato J, Ogawa S. Reversibility of rocuronium-induced profound neuromuscular block with sugammadex in younger and older patients. Br J An- aesth 2011;106:823-6. [CrossRef]
  • McDonagh DL, Benedict PE, Kovac AL, Drover DR, Brister NW, Morte JB, et al. Efficacy, safety and pharmacokinetics of sugam- madex for the reversal of rocuronium-induced neuromuscular blockade in elderly patients. Anesthesiology 2011;114:318-29. [CrossRef]
  • Dinenno FA, Jones PP, Seals DR, Tanaka H. Limb blood flow and vascular conductance are reduced with age in healthy humans: relation to elevations in sympathetic nerve activity and declines in oxygen demand. Circulation 1999;100:164-70. [CrossRef]
  • Sparr HJ, Vermeyen KM, Beaufort AM, Rietbergen H, Proost JH, Saldien V, et al. Early reversal of profound rocuronium- induced neuromuscular block by sugammadex in a randomized multicenter study: Efficacy, safety, and pharmacokinetics. Anes- thesiology 2007;106:935-43. [CrossRef]
  • Gijsenbergh F, Ramael S, Houwing N, van Iersel T. First human exposure of Org 25969, a novel agent to reverse the action of ro- curonium bromide. Anesthesiology 2005;103:695-703. [CrossRef]
  • Pühringer FK, Gordon M, Demeyer I, Sparr HJ, Ingimarsson J, Klarin B, et al. Sugammadex rapidly reverses moderate ro- curonium- or vecuronium-induced neuromuscular block during sevoflurane anaesthesia: a dose-response relationship. Br J An- aesth 2010;105:610-9. [CrossRef]
  • Gatke MR, Viby-Mogensen J, Rosenstock C, Jensen FS, Skovgaard LT. Postoperative muscle paralysis after rocuronium: less residual block when acceleromyography is used. Acta An- aesthesiol Scand 2002;46:207-13. [CrossRef]
  • Debaene B, Plaud B, Dilly MP, Donati F. Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action. Anes- thesiology 2003;98:1042-8. [CrossRef]
  • Murphy GS, Brull SJ. Residual neuromuscular block: lessons unlearned. Part I: definitions, incidence, and adverse physi- ologic effects of residual neuromuscular block. Anesth Analg 2010;111:120-8. [CrossRef]
  • Kaan MN. Postoperative residual neuromuscular blockade. Turkiye Klinikleri J Anest Reanim-Special Topics 2011;4:67-74.
  • Murphy GS, Szokol JW, Marymont JH, Greenberg SB, Avram MJ, Vender JS, et al. Intraoperative acceleromyographic moni- toring reduces risk of residual neuromuscular blockade and ad- verse respiratory events in postanesthesia care unit. Anesthesiol- ogy 2008;109:389-98. [CrossRef]
  • Takagi S, Ozaki M, Kotake Y, Ochiai R, Suzuki T, Ogawa S, et al. Sugammadex has a lower ıncidence of postoperative residual curarization than neostigmine. American Society of Anesthesi- ologists Annual Meeting 2011.
  • Plaud B, Meretoja O, Hofmockel R, Raft J, Stoddart PA, van Kuijk JH, et al. Reversal of rocuronium-induced neuromuscular blockade with sugammadex in pediatric and adult surgical pa- tients. Anesthesiology 2009;110:284-94. [CrossRef]
  • Illman HL, Laurila P, Antila H, Meretoja OA, Alahuhta S, Olkkola K. The duration of residual neuromuscular block af- ter administration of neostigmine or sugammadex at two wis- ible twitches during Train-of-Four monitoring. Anesth Analg 2011;112:63-8. [CrossRef]
  • Duveldestin P, Kuizenga K, Saldien V, Claudius C, Servin F, Klein J, et al. A randomized, dose-response study of sugamma- dex given for the reversal of deep rocuronium- or vecuronium- induced neuromuscular blockade under sevoflurane anesthesia. Anesth Analg 2010;110:74-82. [CrossRef]
  • Eleveld DJ, Kuizenga K, Proost JH, Wierda JM. A temporary decrease in twitch response during reversal of rocuronium- induced muscle relaxation with a small dose of sugammadex. Anesth Analg 2007;104:582-4. [CrossRef]
Balkan Medical Journal-Cover
  • ISSN: 2146-3123
  • Başlangıç: 2015
  • Yayıncı: Erkan Mor
Sayıdaki Diğer Makaleler

Short-Term Outcomes and Mortality of Late Preterm Infants

Fahri OVALI, Tuğba GÜRSOY, Cahide BULUT

Chondroid Syringoma of the Hypothenar Region

R. Doğan KÖSEOĞLU, Fatma MARKOÇ, Bora BOSTAN, A Burcu ARIKAN, Murat AŞCI

Idiopathic Granulomatous Mastitis Associated with Erythema Nodosum

Makbule VARER, Demet ETİT, Melda APAYDIN, Tuğçe Özlem KALAYCI, Melike Bedel KORUYUCU

Load Dependency of Left Ventricular Diastolic Dysfunction Parameters

Mihaela OPRİS, Dan Octavian NİSTOR, Corina Roxana CİMPEAN, Voichita Ileana SİRBU

Oxidative Stress Biomarkers and Adenosine Deaminase over the Alopecic Area of the Patients with Alopecia Areata

Kamil MÜLAYİM, Perihan ÖZTÜRK, Ergül Belge KURUTAŞ, Özer ARICAN

A Comparision of the Effect of Sugammadex on the Recovery Period and Postoperative Residual Block in Young Elderly and Middle-Aged Elderly Patients

Halil Erkan SAYAN, Hülya BİLGİN, Yılmaz APAYDIN, Emine YAZAR, Selcan BAYRAKTAR, Canan YILMAZ, Derya KARASU

Investigating the Impacts of Preoperative Steroid Treatment on Tumor Necrosis Factor-Alpha and Duration of Extubation Time underwent Ventricular Septal Defect Surgery

Funda TOR, Atakan ATALAY, Şerafettin DEMİR, M Kemal AVŞAR, H Hakan POYRAZOĞLU, Zeynel DUMAN, İhsan BAYRAKTAR, Bahattin ÇİFTÇİ

The Investigation of Cortical Auditory Evoked Potentials Responses in Young Adults Having Musical Education

Hanna GARNİER, Jakub WİSNİEWSKİ, Przemyslaw WASZAK

Nasal Bacterial Colonization in Pediatric Epistaxis: The Role of Topical Antibacterial Treatment

Hakan KORKMAZ, Mukadder KORKMAZ, Yeliz ÇETİNKOL, Timur BATMAZ

Benign Cystic Mesothelioma in a Child: Case Report and

Fatma HÜSNİYE DİLEK, Ahmet Ali TUNCER, Salih ÇETİNKURŞUN, Adnan NARCI, Didem EMBLETON BASKIN