Reversal Effects of Sugammadex in Diabetic Patients Having Neuromuscular Block with Rocuronium

OpenAlex İngilizce

Objective: In our study we aimed to compare the time of antagonism and effect of sugammadex which is used for antagonism of rocuronium on diabetic and nondiabetic patients. Sugammadex is a new generation antagonist of neuromuscular blockade which effects by encapsulating rocuronium molecules in the neuromuscular junction through acting like a synthetic receptor of rocuronium. Material and Methods: Included patients were divided into two groups: diabetic (n=21) and non-diabetic (n=20). After loss of eyelid reflex and automatically identification of supramaximal stimulating current by the neuromuscular monitoring system, rocuronium 0.6 mg/kg IV was administered. Train-of-four (TOF) stimulation with the supramaximal current was applied and by recording of second TOF value the patient was intubated. TOF stimulation was performed and recorded every 20 seconds. Intraoperatively by return of T2, rocuronium 0.15 mg/kg IV was administered. T2i time was recorded as intubation time whereas T2d time was recorded as clinical effect time. At the end of the operation sugammadex 2 mg/kg IV was administered. When TOF ratio reached 0.9, patients were extubated and the time interval was recorded. Results: There was no differences between two groups of intubation time (p=0.696). The clinical effect time were 2549.6±913.2 [2360 (1144-4718)] seconds in diabetics and 2208.9±475.0 [2252 (1310-3015)] seconds in non-diabetics (p=0.145). Extubation time (time from sugammadex administration to TOF ratio reaching 0.9) was 434.6±857.1 [205 (67-4120)] seconds in diabetics and 250.4±108.4 [247 (106-462)] seconds in non-diabetics (p= 0.948). Recovery time (time from extubation to reaching an Aldrete's score of 0,9) was 295,19±239,21 [228 (20-945)] seconds in diabetics and 228,20±115,22 [238.5 (54-446)] seconds in non-diabetics (p=0.611). There were no statistical significant difference between the two groups in intubation time, clinical effect time, extubation time and recovery time. Conclusion: Contrary to expected delay of clinical effect and recovery times with conventional reversal agents in diabetic patients resulting from diabetic complications has not occurred with sugammadex. In conclusion, sugammadex seems to be like a good alternative for diabetic patients because of its role in reversing the effects of neuromuscular blocking agents as well as alleviating problems in recovery period.