Du Zhen,Wei Siwei,Xiang Zhen,et al.Comparison of sugammadex versus neostigmine in reducing respiratory complications after extubation in children with adenotonsillectomy[J].Journal of Clinical Pediatric Surgery,,21():546-550.[doi:10.3760/cma.j.cn101785-202205041-009]
Comparison of sugammadex versus neostigmine in reducing respiratory complications after extubation in children with adenotonsillectomy
- Keywords:
- Sugammadex; Adenoidectomy; Tonsillectomy; Rocuronium; Airway Obstruction; Hypoxemia
- Abstract:
- Objective To evaluate the effect of sugammadex on reducing the incidence of respiratory complications immediately after extubation in children undergoing adenotonsillectomy.Methods A total of 90 children with adenoidectomy and/or tonsillectomy were randomly divided into neostigmine + atropine group (N) and sugammadex group (S) (n=45 each).Neuromuscular functions were monitored after anesthesia induction.Rocuronium of 0.6 mg/kg was injected intravenously.When T2 of TOF appeared, group N received an injection of 0.02 mg/kg neostigmin+0.01 mg/kg atropine at the end of operation; Group S had sugammadex 2 mg/kg.Neuromuscular block (NMB) recovery time, extubation time and post anesthesia care unit (PACU) retention time were recorded along with respiratory complications of airway obstruction, hypoxemia, apnea, laryngospasm, bronchospasm, cough, nausea and vomiting.Results After muscle relaxation antagonism, recovery time of NMB was longer in group N than that in group S[(2.8±0.7) vs.(1.7±0.4) min, P<0.001].Compared with group N, extubation time[(29.5±4.4) vs.(20.1±3.6) min, P<0.001]and PACU retention time[(9.2±4.0) vs.(5.0±2.2), P=0.01]were significantly shorter in group S.In group S, 4 children (9%) were fewer than 10 children (22%) in group N with airway obstruction immediately after extubation (P=0.03), 7 children (16%) fewer than 16 children (35%) in group N with hypoxemia (P=0.04) and 1 child (2%) fewer than 5 children (11%) in group N with bronchospasm (P=0.04).Conclusion Compared with neostigmine, use of sugammadex for rocuronium antagonism can not only shorten postoperative extubation time and PACU retention time, but also lower the incidence of airway obstruction, hypoxemia and bronchospasm immediately after extubation in children undergoing adenotonsillectomy.
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Memo
收稿日期:2022-02-10。
基金项目:湖南省自然科学基金（S2019JJQNJJ0583）
通讯作者:屈双权,Email:qushuangquan1974@163.com