Dr. V. Mukesh Kumar, Dr. Y. Venugopalarao
Abstract: BACKGROUND: Residual neuromuscular blockade (RNMB) is a common problem encountered in pediatric patients under general anesthesia with neuromuscular blockade, due to different physiological factors. To accelerate the reversal of neuromuscular blockade and to prevent RNMB, conventionally cholinesterase inhibitors are administered, and since these agents are not selective to nicotinic receptors and also stimulate the muscarinic system, they have multi-systemic side effects. For rapid effective reversal, and to eliminate the muscarinic side effects Sugammadex which is a novel selective relaxant binding agent introduced for reversal of neuromuscular blockade caused by aminosteroidal compounds like rocuronium, even from the deeper blockade AIMS AND OBJECTIVES: This is a cross sectional study to compare the efficacy and safety of suggamadex and neostigmine for reversal of neuromuscular blockade in pediatric patients. The objective of study is to assess the quality of reversal using neostigmine and suggamadex by calculating mean extubation time and recovery time. MATERIALS AND METHODS: A cross sectionl, randomised, double blinded, comparative study was conducted in king George hospital, vishakapatnam. Pediatric patients in the age group of 2- 14years, ASA status 1and 2 Patients are randomly allocated in to two groups RN and RS are the patients receiving neostigmine and sugammadex for reversal. RESULTS Mean extubation time in group RS who received sugammadex is 103.25+25.54sec. Mean extubation time in group RN who received neostigmine is 212.05+60.41sec.P value < 0.0001 showed a highly significant difference in mean extubation time between the two groups. CONCLUSION The present study concluded that sugammadex is making faster and also safer reversal possible for an early extubation when compared with neostigmine in children, for the rocuronium induced neuromuscular blockade.
Keywords: neuromuscular bockade, reversal, pediatric patients, rocuronium, sugammadex, TOF monitoring