Reversal of Rocuronium-Induced Neuromuscular Blockade by Sugammadex Under Sevoflurane and Desflurane Anesthesia in Children.

Abstract

Objective: In children, neuromuscular blockers may have different effects with various inhalation agents and incomplete reversal of the blockade continues to be a problem. The aim of the study is to observe the effects of sugammadex on reversing the blockade by a single dose of rocuronium, the peak inspiratory pressure, hemodynamic parameters in children under sevoflurane and desflurane anesthesia.

Materials and methods: One hundred forty-eight children aged 2-10 years old, to be operated under shortterm general anesthesia, were enrolled in this prospective randomized controlled trial. After induction, the patients were intubated at the end of TOF (Train-of-four) ratio of 1.0-0. The time taken until TOF reached 0.25 was recorded, and 2 mg/kg sugammadex was administered to the patients. The period until the TOF was at least 0.9 and in the first 10 minutes after sugammadex injection, peak inspiratory pressure, the systolic-diastolic arterial pressure, and the heart rate were monitored and possible side effects were observed in the recovery room.

Results: Following the injection of sugammadex, the time taken for TOF of 0.25 to reach >0.9 was significantly shorter in the 2-4-year-old age group under sevoflurane anesthesia. After sugammadex injection, a small but statistically significant increase in peak inspiratory pressure values was observed in Group D at the 2nd, 5th, and 10th minutes.

Conclusion: Rapid and complete recovery was achieved from the block induced by a single dose of 0.6 mg/ kg rocuronium by the use of sugammadex which did not give rise to any side effects.