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

Laparoscopic Cholecystectomy 수술 후 Sugammadex와 Neostigmine 간에 첫 자발호흡과 부작용 발현 연구

  • Park, HyunSuk (Graduate School of Converging Clinical and Public Health, Ewha Womans University) ;
  • Park, Moon Soo (Department of Orthopaedic Surgery Hallym University Sacred Heart Hospital and, Medical College of Hallym University) ;
  • Kim, Min Jung (Department of Pharmacy, Seoul National University Hospital) ;
  • Kim, Kwi Suk (Department of Pharmacy, Seoul National University Hospital) ;
  • Cho, Yoon Sook (Department of Pharmacy, Seoul National University Hospital) ;
  • Bae, Seng Sim (Department of Nursing, Seoul National University Hospital) ;
  • Rhie, Sandy Jeong (Graduate School of Converging Clinical and Public Health, Ewha Womans University)
  • 박현숙 (이화여자대학교 임상보건융합대학원) ;
  • 박문수 (한림대학교 성심병원 척추센터) ;
  • 김민정 (서울대학교병원 약제부) ;
  • 김귀숙 (서울대학교병원 약제부) ;
  • 조윤숙 (서울대학교병원 약제부) ;
  • 배성심 (서울대학교병원 간호부) ;
  • 이정연 (이화여자대학교 임상보건융합대학원)
  • Received : 2018.06.06
  • Accepted : 2018.06.22
  • Published : 2018.06.29

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.

Keywords

References

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