Salin yıkamasının sugammadeksin başlangıç zamanı üzerine etkisi: Randomize klinik çalışma

Amaç: Sugammadeksin etkisinin başlama süresini kısaltmak için çeşitli yöntemler uygulanmıştır. Bu çalışmanın amacı, sugammadeks uygulamasından hemen sonra uygulanan 20 mL serum fizyolojik bolusun, dörtlü uyarı dizisi (TOF) yöntemi ile izlenilerek, etki başlangıç süresini incelemektir.Yöntemler: Yerel Etik Kurul onamı sonrası Ağustos 2017- Ocak 2018 arası genel anestezi altında elektif cerrahi planlanan, ASA I-II statüde, operasyon süresi 1-3 saat sürecek, 18-65 yaş arasında 60 hasta çalışmaya dahil edildi. Hastalar rastgele Grup S (Serum Fizyolojik grubu, n=30) ve Grup C (Kontrol grubu, n=30) olmak üzere iki gruba ayrıldı. Serum Fizyolojik grubuna 2 mg/kg sugammadeks uygulamasından hemen sonra 20 cc izotonik serum fizyolojik bolus olarak uygulandı. Kontrol grubuna ise sadece 2 mg/kg sugammadeks verildi. Nöromüsküler bloğun izlemi için TOF monitörü kullanıldı. Elektrokardiyografi, oksijen satürasyonu, noninvaziv arteriyel basınç ve TOF izleme cihazı ile ölçülen akseleromiyelografi değerleri kaydedildi ve gruplar arasında karşılaştırıldı. Tüm hastalar ameliyat sırasında ve ameliyattan 30 dakika sonra monitorize olarak izlendi.Bulgular: Her iki grupta temel klinik özellikler ve demografik veriler açısından benzerdi. Gruplar arasında TOF'un 0,2'den 0,9'a ulaşması açısından istatistiksel olarak anlamlı bir fark vardı. TOF'un 0,2'den 0,9'a ulaşma süresi Serum Fizyolojik grubunda kontrol grubuna göre anlamlı olarak düşük tespit edildi (85,4'e ve 130,5 saniye; P=0,001).Sonuç: Çalışmamız göstermiştir ki, sugammadeks uygulamasından hemen sonra uygulanan 20 ml serum fizyolojiğin sugammadeksin etki başlangıç zamanını kısalttığını göstermiştir.

Anahtar Kelimeler:

Serum fizyolojik, Neuromuscular block, Dörtlü uyarı dizisi izlemi, Sugammadex

Effect of saline flush on the onset time of sugammadex: A randomized clinical study

Aim: Several methods have been tried out to shorten the onset time of sugammadex. The objective of this study was to examine the effect of 20 mL saline flush administered immediately after sugammadex on its onset time by using train-of-four (TOF) monitoring.Methods: This study was initiated after obtaining the approval of the institutional Medical Research Ethics Committee. A total of 60 ASA I-II patients aged between 18-65 years scheduled for elective abdominal surgery in our hospital between August 2017 and January 2018, which would last 1-3 hours under general anesthesia, were enrolled in this study. Patients were randomly divided into two groups as Group S (saline flush group, n=30) and Group C (control group, n=30). Saline flush group received 2 mg/kg sugammadex and 20 ml isotonic saline flush immediately after sugammadex administration, while the control group received 2 mg/kg sugammadex only. TOF monitoring was used to assess neuromuscular block. Electrocardiography, oxygen saturation, noninvasive arterial pressure as well as acceleromyography values measured by TOF monitoring device were recorded and compared between the groups. All patients were continuously monitored intraoperatively and 30 minutes postoperatively.Results: Both groups were similar in terms of basic clinical characteristics and demographics. There was a statistically significant difference between the groups in terms of the time of TOF to reach 0.9 from 0.2. The mean time of TOF to reach 0.9 from 0.2 was lower in Saline flush group than in control group (85.4 vs 130.5 seconds; P=0.001).Conclusion: Our study demonstrated that 20 mL saline flush administered immediately after sugammadex shortened the onset time of sugammadex.

Keywords:

Saline solution, Neuromuscular block, Train-of-four monitoring, Sugammadex,

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