Pediatrik olgularda uygulanan rijit bronkoskopi işleminde anestezi derlemesinde sugammadeks ve neostigminin etkinliğininin karşılaştırılması
Year 2022,
Volume: 8 Issue: 2, 136 - 141, 30.08.2022
Mehmet Duran
,
Mehmet Tepe
,
Mehmet Şirin Mağaç
,
Öğünç Apaydın
,
Mevlüt Doğukan
,
Çiğdem Demirci
Abstract
Amaç: Trakeobronşiyal yabancı cisim aspirasyonu nedeniyle rijit bronkoskopi yapılan çocuklarda roküronyumun neden olduğu nöromüsküler blokajın tersine çevrilmesinde kullanılan sugammadeks ve neostigminin etkinliğininin karşılaştırılması amaçlanmıştır.
Gereç ve Yöntem: Hastanemizde 2013-2018 tarihleri arasında 0-18 yaş grubu çocuklarda, yabancı cisim aspirasyonu şüphesi ile rijit bronkoskopi yapılan 54 hastanın verileri geriye dönük olarak incelendi.
Bulgular: Olguların 30’u erkek, 24’ü kızdı. Nöromüsküler blokajın tersine çevrilmesi amacıyla, 23 olguya atropin- neostigmin ve 31 olguya da sugammadeks uygulanmıştı. 41 olguda komplikasyon saptanmazken 6 olguda bronkospazm, 5 olguda hipoksi, 2 olguda laringospazm saptandı. Derlenme süresi sugammadeks uygulanan olgularda daha kısa tespit edilmiştir (p<0,001).
Sonuç: Pediyatrik rijit bronkoskopi anestezi uygulamasında roküronyumun neden olduğu nöromüsküler blokajın tersine çevrilmesinde, sugammadeks uygulanması sonrası derlenme süresi daha kısadır.
Supporting Institution
yok
References
- Brkic F, Umihanic S, Altumbabic H, et al. Death as a Consequence of Foreign Body Aspiration in Children. Med Arch. 2018;72(3):220-223. doi:10.5455/medarh.2018.72.220-223
- Liu J, Xiao K, Lv X. Anesthesia and ventilation for removal of airway foreign bodies in 35 infants. Int J Clin Exp Med. 2014;7(12):5852-5856. Published 2014 Dec 15.
- Rangalakshmi S, Dixit N. Anesthetic management in removal of neglected tracheobronchial foreign body. J Anaesthesiol Clin Pharmacol. 2013;29(1):127-128. doi:10.4103/0970-9185.105825
- Farrell PT. Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation. Paediatr Anaesth. 2004;14(1):84-89. doi:10.1046/j.1460-9592.2003.01194.x
- Soodan A, Pawar D, Subramanium R. Anesthesia for removal of inhaled foreign bodies in children. Paediatr Anaesth. 2004;14(11):947-952. doi:10.1111/j.1460-9592.2004.01309.x
- Soysal O, Kuzucu A, Ulutas H. Tracheobronchial foreign body aspiration: a continuing challenge. Otolaryngol Head Neck Surg. 2006;135(2):223-226. doi:10.1016/j.otohns.2005.09.035
- Nicholson WT, Sprung J, Jankowski CJ. Sugammadex: a novel agent for the reversal of neuromuscular blockade. Pharmacotherapy. 2007;27(8):1181-1188. doi:10.1592/phco.27.8.1181
- Bhaskar SB. Emergence from anaesthesia: Have we got it all smoothened out?. Indian J Anaesth. 2013;57(1):1-3. doi:10.4103/0019-5049.108549
- Sinha V, Chhaya V, Barot DS, et al. Foreign body in tracheobronchial tree. Indian J Otolaryngol Head Neck Surg. 2010;62(2):168-170. doi:10.1007/s12070-010-0044-2
- Zhang J, Wang Y, Li B, Zhang W. Remifentail infusion for paediatric bronchoscopic foreign body removal: comparison of sevoflurane with propofol for anaesthesia supplementation for bronchoscope insertion. Anaesth Intensive Care. 2010;38(5):905-910. doi:10.1177/0310057X1003800431
- Liao R, Li JY, Liu GY. Comparison of sevoflurane volatile induction/maintenance anaesthesia and propofol-remifentanil total intravenous anaesthesia for rigid bronchoscopy under spontaneous breathing for tracheal/bronchial foreign body removal in children. Eur J Anaesthesiol. 2010;27(11):930-934. doi:10.1097/EJA.0b013e32833d69ad
- Kendigelen P. The anaesthetic consideration of tracheobronchial foreign body aspiration in children. J Thorac Dis. 2016;8(12):3803-3807. doi:10.21037/jtd.2016.12.69
- Karaaslan E, Yildiz T. Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration. Pak J Med Sci. 2019;35(6):1592-1597. doi:10.12669/pjms.35.6.1225
- Fitzpatrick PC, Guarisco JL. Pediatric airway foreign bodies. J La State Med Soc. 1998;150(4):138-141.
- Hayes AH, Mirakhur RK, Breslin DS, Reid JE, McCourt KC. Postoperative residual block after intermediate-acting neuromuscular blocking drugs. Anaesthesia. 2001;56(4):312-318. doi:10.1046/j.1365-2044.2001.01921.x
- Sorgenfrei IF, Norrild K, Larsen PB, et al. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study. Anesthesiology. 2006;104(4):667-674. doi:10.1097/00000542-200604000-00009
- Bom A, Bradley M, Cameron K, et al. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. Angew Chem Int Ed Engl. 2002;41(2):266-270. doi:10.1002/1521-3773(20020118)41:2<265::aid-anie265>3.0.co;2-q
- Carron M, Zarantonello F, Tellaroli P, Ori C. Efficacy and safety of sugammadex compared to neostigmine for reversal of neuromuscular blockade: a meta-analysis of randomized controlled trials. J Clin Anesth. 2016;35:1-12. doi:10.1016/j.jclinane.2016.06.018
- Ammar AS, Mahmoud KM, Kasemy ZA. A comparison of sugammadex and neostigmine for reversal of rocuronium-induced neuromuscular blockade in children. Acta Anaesthesiol Scand. 2017;61(4):374-380. doi:10.1111/aas.12868
- Li L, Jiang Y, Zhang W. Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery: A Randomized Controlled Study. J Cardiothorac Vasc Anesth. 2021;35(5):1388-1392. doi:10.1053/j.jvca.2020.08.069
- Won YJ, Lim BG, Lee DK, Kim H, Kong MH, Lee IO. Sugammadex for reversal of rocuronium-induced neuromuscular blockade in pediatric patients: A systematic review and meta-analysis. Medicine (Baltimore). 2016;95(34):e4678. doi:10.1097/MD.0000000000004678
- Mogahed MM, Mohamed RM, Hamed JME. Sugammadex Efficacy for Rapid Reversal of Rocuronium Induced Neuromuscular Blockade in Pediatric Rigid Bronchoscopy Regardless the Depth of Anesthesia. J Anesth Clin Res. 2017, 8.769: 2.
- Korkmaz MO, Sayhan H, Guven M. Does sugammadex decrease the severity of agitation and complications in pediatric patients undergoing adenotonsillectomy?. Saudi Med J. 2019;40(9):907-913. doi:10.15537/smj.2019.9.24485
- Franz AM, Chiem J, Martin LD, Rampersad S, Phillips J, Grigg EB. Case series of 331 cases of sugammadex compared to neostigmine in patients under 2 years of age. Paediatr Anaesth. 2019;29(6):591-596. doi:10.1111/pan.13643
Comparison of the effects of sugammadex and neostigmine on recovery of anesthesia in rigid bronchoscopy in pediatric cases
Year 2022,
Volume: 8 Issue: 2, 136 - 141, 30.08.2022
Mehmet Duran
,
Mehmet Tepe
,
Mehmet Şirin Mağaç
,
Öğünç Apaydın
,
Mevlüt Doğukan
,
Çiğdem Demirci
Abstract
Aim: To compare the efficacy of sugammadex and neostigmine, which are used to reverse rocuronium- neuromuscular blockade in children who underwent rigid bronchoscopy due to tracheobronchial foreign body aspiration.
Materials and Methods: The data of 54 patients who underwent rigid bronchoscopy with the suspicion of foreign body aspiration in children aged 0-18 in our hospital between 2013 and 2018 were retrospectively analyzed.
Results: Thirty of the cases were male and 24 were female. Atropine-neostigmine was administered to 23 patients and sugammadex was administered to 31 patients to reverse neuromuscular blockade. While no complications were found in 41 cases, bronchospasm was found in 6 cases, hypoxia in 5 cases, and laryngospasm in 2 cases. Recovery time was shorter in patients who received sugammadex (p<0.001).
Conclusion: Recovery time is shorter after sugammadex administration in reversing rocuronium-induced neuromuscular blockade in pediatric rigid bronchoscopy anesthesia.
References
- Brkic F, Umihanic S, Altumbabic H, et al. Death as a Consequence of Foreign Body Aspiration in Children. Med Arch. 2018;72(3):220-223. doi:10.5455/medarh.2018.72.220-223
- Liu J, Xiao K, Lv X. Anesthesia and ventilation for removal of airway foreign bodies in 35 infants. Int J Clin Exp Med. 2014;7(12):5852-5856. Published 2014 Dec 15.
- Rangalakshmi S, Dixit N. Anesthetic management in removal of neglected tracheobronchial foreign body. J Anaesthesiol Clin Pharmacol. 2013;29(1):127-128. doi:10.4103/0970-9185.105825
- Farrell PT. Rigid bronchoscopy for foreign body removal: anaesthesia and ventilation. Paediatr Anaesth. 2004;14(1):84-89. doi:10.1046/j.1460-9592.2003.01194.x
- Soodan A, Pawar D, Subramanium R. Anesthesia for removal of inhaled foreign bodies in children. Paediatr Anaesth. 2004;14(11):947-952. doi:10.1111/j.1460-9592.2004.01309.x
- Soysal O, Kuzucu A, Ulutas H. Tracheobronchial foreign body aspiration: a continuing challenge. Otolaryngol Head Neck Surg. 2006;135(2):223-226. doi:10.1016/j.otohns.2005.09.035
- Nicholson WT, Sprung J, Jankowski CJ. Sugammadex: a novel agent for the reversal of neuromuscular blockade. Pharmacotherapy. 2007;27(8):1181-1188. doi:10.1592/phco.27.8.1181
- Bhaskar SB. Emergence from anaesthesia: Have we got it all smoothened out?. Indian J Anaesth. 2013;57(1):1-3. doi:10.4103/0019-5049.108549
- Sinha V, Chhaya V, Barot DS, et al. Foreign body in tracheobronchial tree. Indian J Otolaryngol Head Neck Surg. 2010;62(2):168-170. doi:10.1007/s12070-010-0044-2
- Zhang J, Wang Y, Li B, Zhang W. Remifentail infusion for paediatric bronchoscopic foreign body removal: comparison of sevoflurane with propofol for anaesthesia supplementation for bronchoscope insertion. Anaesth Intensive Care. 2010;38(5):905-910. doi:10.1177/0310057X1003800431
- Liao R, Li JY, Liu GY. Comparison of sevoflurane volatile induction/maintenance anaesthesia and propofol-remifentanil total intravenous anaesthesia for rigid bronchoscopy under spontaneous breathing for tracheal/bronchial foreign body removal in children. Eur J Anaesthesiol. 2010;27(11):930-934. doi:10.1097/EJA.0b013e32833d69ad
- Kendigelen P. The anaesthetic consideration of tracheobronchial foreign body aspiration in children. J Thorac Dis. 2016;8(12):3803-3807. doi:10.21037/jtd.2016.12.69
- Karaaslan E, Yildiz T. Management of anesthesia and complications in children with Tracheobronchial Foreign Body Aspiration. Pak J Med Sci. 2019;35(6):1592-1597. doi:10.12669/pjms.35.6.1225
- Fitzpatrick PC, Guarisco JL. Pediatric airway foreign bodies. J La State Med Soc. 1998;150(4):138-141.
- Hayes AH, Mirakhur RK, Breslin DS, Reid JE, McCourt KC. Postoperative residual block after intermediate-acting neuromuscular blocking drugs. Anaesthesia. 2001;56(4):312-318. doi:10.1046/j.1365-2044.2001.01921.x
- Sorgenfrei IF, Norrild K, Larsen PB, et al. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study. Anesthesiology. 2006;104(4):667-674. doi:10.1097/00000542-200604000-00009
- Bom A, Bradley M, Cameron K, et al. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. Angew Chem Int Ed Engl. 2002;41(2):266-270. doi:10.1002/1521-3773(20020118)41:2<265::aid-anie265>3.0.co;2-q
- Carron M, Zarantonello F, Tellaroli P, Ori C. Efficacy and safety of sugammadex compared to neostigmine for reversal of neuromuscular blockade: a meta-analysis of randomized controlled trials. J Clin Anesth. 2016;35:1-12. doi:10.1016/j.jclinane.2016.06.018
- Ammar AS, Mahmoud KM, Kasemy ZA. A comparison of sugammadex and neostigmine for reversal of rocuronium-induced neuromuscular blockade in children. Acta Anaesthesiol Scand. 2017;61(4):374-380. doi:10.1111/aas.12868
- Li L, Jiang Y, Zhang W. Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery: A Randomized Controlled Study. J Cardiothorac Vasc Anesth. 2021;35(5):1388-1392. doi:10.1053/j.jvca.2020.08.069
- Won YJ, Lim BG, Lee DK, Kim H, Kong MH, Lee IO. Sugammadex for reversal of rocuronium-induced neuromuscular blockade in pediatric patients: A systematic review and meta-analysis. Medicine (Baltimore). 2016;95(34):e4678. doi:10.1097/MD.0000000000004678
- Mogahed MM, Mohamed RM, Hamed JME. Sugammadex Efficacy for Rapid Reversal of Rocuronium Induced Neuromuscular Blockade in Pediatric Rigid Bronchoscopy Regardless the Depth of Anesthesia. J Anesth Clin Res. 2017, 8.769: 2.
- Korkmaz MO, Sayhan H, Guven M. Does sugammadex decrease the severity of agitation and complications in pediatric patients undergoing adenotonsillectomy?. Saudi Med J. 2019;40(9):907-913. doi:10.15537/smj.2019.9.24485
- Franz AM, Chiem J, Martin LD, Rampersad S, Phillips J, Grigg EB. Case series of 331 cases of sugammadex compared to neostigmine in patients under 2 years of age. Paediatr Anaesth. 2019;29(6):591-596. doi:10.1111/pan.13643