Tek Doz Metilprednizolon Uygulamasının Nöromusküler Blokajın Sugammadeks ile Geri Çevrilmesine Etkisi

Abstract

Sugammadex provides effective and rapid reversal of neuromuscular blockade. Although drug interaction of sugammadex is rare, it was reported that dexametazone suppresses sugammadex. Our aim in this study is to investigate whether methylprednisolone, a molecule similar to dexamethasone, has similar effect on the activity of sugammadex. After obtaining approval of the ethics committee a total of 71 patients undergoing thyroid surgery, breast surgery and simple intraabdominal surgeries were included in the study. Patients were divided into two groups: methylprednisolone group (Group M) and control group (Group C). Electrocardiography (ECG), SpO2 (percentage of peripheral oxygen saturation) and non-invasive blood pressure monitoring were applied routinely to the patients and rocuronium-related neuromuscular blockade was evaluated by TOF monitoring. Our primary outcome is extubation times after sugammadex administration (TOF> 0.9), were compared between groups. The extubation time after sugammadex administration was 5.561 ± 4,065 min (min: 1 min, max: 17 min) in Group M and 3.364 ± 2,194 min (min: 1 min, max: 11 min) in Group C. The extubation time in methylprednisolone group was found to be significantly higher than the control group (p = 0.017). Since the duration of surgery was also significantly different between groups, the effect of the time to achieve a TOFr > 0.9 and methylprednizolon administration on the extubation time after administration of sugammadex was evaluated by regression analysis and it was shown that methylprednisolone usage independently affected the time of extubation after sugammadex administration (p = 0.011). In conclusion, while the use of methylprednisolone is thought to be effective on the duration of extubation after the administration of sugammadex, studies are needed in larger series with patients in the same depth of neuromuscular blockade and where the plasma methylprednisolone concentrations are also evaluated.