Korean J Clin Pharm.  2018 Jun;28(2):101-106. 10.24304/kjcp.2018.28.2.101.

Comparison of Sugammadex and Neostigmine on First Spontaneous Breathing and Adverse Effects for Laparoscopic Cholecystectomy

Affiliations
  • 1Graduate School of Converging Clinical and Public Health, Ewha Womans University, Seoul 03760, Republic of Korea. sandy.rhie@ewha.ac.kr
  • 2Department of Pharmacy, Seoul National University Hospital, Seoul 03080, Republic of Korea.
  • 3Department of Orthopaedic Surgery Hallym University Sacred Heart Hospital and, Medical College of Hallym University, Anyang-si 14068, Republic of Korea.
  • 4Department of Nursing, Seoul National University Hospital, Seoul 03080, Republic of Korea.
  • 5College of Pharmacy & Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Republic of Korea.

Abstract


OBJECTIVE
The purpose of the study was to investigate the time from the injection of muscle relaxants to the first spontaneous respiration between sugammadex and conventional reversal for patients undergoing laparoscopic cholecystectomy.
METHODS
This study was retrospectively conducted on patients who were diagnosed with gallbladder stone (N802) between January 2014 and April 2017. The data were collected from the electronic medical records of a total of 186 patients (84 patients in the neostigmine group and 102 patients in the sugammadex group).
RESULTS
The time required for the first spontaneous respiration in the sugammadex group was shorter than that in the neostigmine group (3.6 min vs 4.9 min; p < 0.05). After the injection of intermediate muscle relaxants, the comparison of heart rate and mean arterial pressure in the sugammadex and neostigmine groups revealed that the heart rate in the neostigmine group was higher than in the sugammadex group after 5 min (p < 0.05). The mean arterial pressure in the neostigmine group was higher than in the sugammadex group after 10 min (p < 0.05). A significant adverse effect of tachycardia was observed in the neostigmine group (p < 0.05), but the frequency of rescue antiemetic in the sugammadex group was significantly higher than in the neostigmine group (p < 0.05).
CONCLUSION
In this study, the unwanted effect of neostigmine group was tachycardia; therefore, in the case of patients with hemodynamic instability, sugammadex is recommended. At 12 hours after the injection of sugammadex to patients, more antiemetics were required than in the neostigmine group; therefore, more research should be conducted on postoperative nausea and vomiting.

Keyword

Sugammadex; neostigmine; muscle relaxants; laparoscopic cholecystectomy; antiemetic

MeSH Terms

Antiemetics
Arterial Pressure
Cholecystectomy, Laparoscopic*
Electronic Health Records
Gallbladder
Heart Rate
Hemodynamics
Humans
Neostigmine*
Postoperative Nausea and Vomiting
Respiration*
Retrospective Studies
Tachycardia
Antiemetics
Neostigmine
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