The influence of mild hypothermia on reversal of rocuronium-induced deep neuromuscular block with sugammadex.

BMC Anesthesiol

Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, #17 Haengdang dong, Sungdong gu, Seoul, 133-792, Korea.

Published: January 2015

Background: Mild hypothermia may be frequently induced due to cool environments in the operating room. The study analyzed patient recovery time and response to sugammadex after a prolonged rocuronium-induced deep neuromuscular block (NMB) during mild hypothermia.

Methods: Sixty patients were randomly (1:1) allocated to the mild hypothermia and normothermia groups, defined as having core temperatures between 34.5-35°C and 36.5-37°C, respectively. Patients received 0.6 mg/kg of rocuronium, followed by 7-10 μg/kg/min to maintain a deep NMB [post-tetanic count (PTC) 1-2]. After surgery, the deep NMB was reversed with sugammadex 4.0 mg/kg. The primary end-point was the time until the train-of-four (TOF) ratio was 0.9.

Results: The appropriate neuromuscular function (TOF ratio ≥ 0.9) was restored after sugammadex was administered, even after hypothermia. The length of recovery in the hypothermia patients [mean (SD), 171.1 (62.1) seconds (s)] was significantly slower compared with the normothermia patients [124.9 (59.2) s] (p = 0.005). There were no adverse effects from sugammadex.

Conclusions: Sugammadex safely and securely reversed deep rocuronium-induced NMB during mild hypothermia. An additional 46 s was required for recovery from a deep NMB in hypothermia patients. Based on the results, we think this prolonged recovery time is clinically acceptable.

Trial Registration: ClinicalTrials.gov Identifier: NCT01965067.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430027PMC
http://dx.doi.org/10.1186/1471-2253-15-7DOI Listing

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