Farahat, T., Mousa, S. (2022). Cerebral Oxygenation and Metabolism after Reversal of Rocuronium: Comparison between Sugammadex versus Neostigmine. The Egyptian Journal of Hospital Medicine, 89(1), 4176-4186. doi: 10.21608/ejhm.2022.256319
tamer Farahat; Sherif Abdo Mousa. "Cerebral Oxygenation and Metabolism after Reversal of Rocuronium: Comparison between Sugammadex versus Neostigmine". The Egyptian Journal of Hospital Medicine, 89, 1, 2022, 4176-4186. doi: 10.21608/ejhm.2022.256319
Farahat, T., Mousa, S. (2022). 'Cerebral Oxygenation and Metabolism after Reversal of Rocuronium: Comparison between Sugammadex versus Neostigmine', The Egyptian Journal of Hospital Medicine, 89(1), pp. 4176-4186. doi: 10.21608/ejhm.2022.256319
Farahat, T., Mousa, S. Cerebral Oxygenation and Metabolism after Reversal of Rocuronium: Comparison between Sugammadex versus Neostigmine. The Egyptian Journal of Hospital Medicine, 2022; 89(1): 4176-4186. doi: 10.21608/ejhm.2022.256319
Cerebral Oxygenation and Metabolism after Reversal of Rocuronium: Comparison between Sugammadex versus Neostigmine
Anesthesia and Intensive Care and pain managment department faculty of medicine Mansoura University
Abstract
Background: Recovery from neuroanesthesia requires stable hemodynamics and optimal cerebral oxygenation. Objective: The purpose of this study was to compare the effect of low dose sugammadex with neostigmine on recovery and cerebral hemodynamic profile after supratentorial tumor resection. Patients and Methods: In this double-blind randomized study, forty patients were allocated according to the reversal used after supratentorial tumor surgery into, sugammadex 2 mg·kg–1 (group S) or neostigmine 0.05 mg·kg–1 + atropine 0.02 mg·kg–1 (group N). Duration from reversal to train of four 0.9 was a primary outcome. Arterial and jugular bulb blood samples obtained after induction, before closure of dura, before reversal, ten minutes after reversal then one hourly for 3 hours postoperative for the calculation of arterial-jugular oxygen content difference “CaO2-jO2,” cerebral oxygen extraction “CEO2”, jugular venous oxygen saturation (SjvO2), estimated cerebral metabolic rate “eCMRO2,” and cerebral blood flow equivalent “CBFe,” as secondary outcomes. Results: We demonstrated that recovery time (duration from reversal to train of four 0.9) was significantly shorter with sugammadex (P=0.001). Sugammadex recorded significant increased CEO2 and CaO2-jO2 at 10 minutes after reversal, at 1 hour (hr), 2 hr and 3 hr postoperatively. Sugammadex resulted in significant decreased SjvO2 and CBFe at 10 minutes after reversal, at 1 hr, 2 hr and 3 hr postoperatively without significant effect on eCMRO2. Conclusion: Low dose sugammadex (2 mg.kg-1) provided rapid and effective reversal of rocuronium NMB superior to neostigmine with improved cerebral hemodynamic profile after supratentorial tumor surgery.
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