Effects of Sugammadex versus Neostigmine on Intraoperative Coagulation Profiles in Patients with Thyroidectomy

Sugammadex has been a revolutionary reversal of neuromuscular blockade. It is known to be highly efficient. However, a change in the coagulation profile is one of the most dangerous potential complications which is a concern for both surgeon and anesthetist. Bleeding may cause hypovolemic shock, hem...

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Published in:Drug design, development and therapy development and therapy, 2021-01, Vol.15, p.829-834
Main Authors: Zhao, Dizhou, Fang, Jieyu, Xiong, Wei, Lin, Jun, Chen, Wanmei, Wu, Chujun
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anesthesia
Bleeding
Blood
Blood coagulation factors
Blood Coagulation Tests
Clinical Trial Report
Coagulation
Comparative analysis
Complications
Drug dosages
Female
Fibrin
Fibrinogen
Heart rate
Hematoma
Humans
Intubation
Male
Medical examination
Middle Aged
Neoplasms
Neostigmine
Neostigmine - administration & dosage
Neostigmine - therapeutic use
Neuromuscular Blockade
Neuromuscular blocking agents
Patients
Propofol
Prothrombin
Reaction time
Remifentanil
Statistical analysis
Sufentanil
sugammadex
Sugammadex - administration & dosage
Sugammadex - therapeutic use
Surgeons
teg-haemonetics
Thrombin
Thromboplastin
Thyroid
Thyroid Neoplasms - drug therapy
Thyroid Neoplasms - surgery
Thyroidectomy
Trachea
Values
Young Adult
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cited_by cdi_FETCH-LOGICAL-c576t-8688c8ffd9d770a23836c3fb64b96d41db62c9e4ab3efd4beabbfee497f211b33
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container_start_page 829
container_title Drug design, development and therapy
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creator Zhao, Dizhou
Fang, Jieyu
Xiong, Wei
Lin, Jun
Chen, Wanmei
Wu, Chujun
description Sugammadex has been a revolutionary reversal of neuromuscular blockade. It is known to be highly efficient. However, a change in the coagulation profile is one of the most dangerous potential complications which is a concern for both surgeon and anesthetist. Bleeding may cause hypovolemic shock, hematoma, and so on. To investigate the effects of sugammadex on coagulation profiles in patients with thyroidectomy, we compared patients that were treated with either sugammadex or neostigmine. Eighty patients with thyroid neoplasms undergoing thyroidectomy were randomly allocated to sugammadex group (group S) or neostigmine group (group N). Induction of anesthesia was preformed using propofol, sufentanil, and rocuronium. Group S received sugammadex 2.0mg/kg after trachea intubation, similarly Group N received neostigmine 40 µg/kg, for reversal of rocuronium-induced neuromuscular blockade. The intraoperative coagulation profiles were monitored after the rocuronium injection (T0), 10 minutes after reversal (T1) and 30 minutes after reversal (T2) by testing activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), thrombin time (TT), and TEG-Haemonetics. Amount of bleeding was recorded during perioperative period. There was no significant difference in the thromboelastogram, APTT, PT, FIB, or TT measurements at each time point in Group N. The reaction time (R time) and kinetics time (K time) of Group S in T1 were significantly longer than the corresponding times at T0 and T2, and the R times were significantly longer than those in Group N at the same time points (P
doi_str_mv 10.2147/DDDT.S286803
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It is known to be highly efficient. However, a change in the coagulation profile is one of the most dangerous potential complications which is a concern for both surgeon and anesthetist. Bleeding may cause hypovolemic shock, hematoma, and so on. To investigate the effects of sugammadex on coagulation profiles in patients with thyroidectomy, we compared patients that were treated with either sugammadex or neostigmine. Eighty patients with thyroid neoplasms undergoing thyroidectomy were randomly allocated to sugammadex group (group S) or neostigmine group (group N). Induction of anesthesia was preformed using propofol, sufentanil, and rocuronium. Group S received sugammadex 2.0mg/kg after trachea intubation, similarly Group N received neostigmine 40 µg/kg, for reversal of rocuronium-induced neuromuscular blockade. The intraoperative coagulation profiles were monitored after the rocuronium injection (T0), 10 minutes after reversal (T1) and 30 minutes after reversal (T2) by testing activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), thrombin time (TT), and TEG-Haemonetics. Amount of bleeding was recorded during perioperative period. There was no significant difference in the thromboelastogram, APTT, PT, FIB, or TT measurements at each time point in Group N. The reaction time (R time) and kinetics time (K time) of Group S in T1 were significantly longer than the corresponding times at T0 and T2, and the R times were significantly longer than those in Group N at the same time points (P&lt;0.05). Additionally, in Group S, the APTT was prolonged in T1 and returned to normal in T2. The result showed that sugammadex provided transient efficacy in prolonging the coagulation parameters, while neostigmine did not change the coagulation profile.</description><identifier>ISSN: 1177-8881</identifier><identifier>EISSN: 1177-8881</identifier><identifier>DOI: 10.2147/DDDT.S286803</identifier><identifier>PMID: 33658764</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Adolescent ; Adult ; Aged ; Anesthesia ; Bleeding ; Blood ; Blood coagulation factors ; Blood Coagulation Tests ; Clinical Trial Report ; Coagulation ; Comparative analysis ; Complications ; Drug dosages ; Female ; Fibrin ; Fibrinogen ; Heart rate ; Hematoma ; Humans ; Intubation ; Male ; Medical examination ; Middle Aged ; Neoplasms ; Neostigmine ; Neostigmine - administration &amp; dosage ; Neostigmine - therapeutic use ; Neuromuscular Blockade ; Neuromuscular blocking agents ; Patients ; Propofol ; Prothrombin ; Reaction time ; Remifentanil ; Statistical analysis ; Sufentanil ; sugammadex ; Sugammadex - administration &amp; dosage ; Sugammadex - therapeutic use ; Surgeons ; teg-haemonetics ; Thrombin ; Thromboplastin ; Thyroid ; Thyroid Neoplasms - drug therapy ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Trachea ; Values ; Young Adult</subject><ispartof>Drug design, development and therapy, 2021-01, Vol.15, p.829-834</ispartof><rights>2021 Zhao et al.</rights><rights>COPYRIGHT 2021 Dove Medical Press Limited</rights><rights>2021. 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It is known to be highly efficient. However, a change in the coagulation profile is one of the most dangerous potential complications which is a concern for both surgeon and anesthetist. Bleeding may cause hypovolemic shock, hematoma, and so on. To investigate the effects of sugammadex on coagulation profiles in patients with thyroidectomy, we compared patients that were treated with either sugammadex or neostigmine. Eighty patients with thyroid neoplasms undergoing thyroidectomy were randomly allocated to sugammadex group (group S) or neostigmine group (group N). Induction of anesthesia was preformed using propofol, sufentanil, and rocuronium. Group S received sugammadex 2.0mg/kg after trachea intubation, similarly Group N received neostigmine 40 µg/kg, for reversal of rocuronium-induced neuromuscular blockade. 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The result showed that sugammadex provided transient efficacy in prolonging the coagulation parameters, while neostigmine did not change the coagulation profile.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Bleeding</subject><subject>Blood</subject><subject>Blood coagulation factors</subject><subject>Blood Coagulation Tests</subject><subject>Clinical Trial Report</subject><subject>Coagulation</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Fibrin</subject><subject>Fibrinogen</subject><subject>Heart rate</subject><subject>Hematoma</subject><subject>Humans</subject><subject>Intubation</subject><subject>Male</subject><subject>Medical examination</subject><subject>Middle Aged</subject><subject>Neoplasms</subject><subject>Neostigmine</subject><subject>Neostigmine - administration &amp; dosage</subject><subject>Neostigmine - therapeutic use</subject><subject>Neuromuscular Blockade</subject><subject>Neuromuscular blocking agents</subject><subject>Patients</subject><subject>Propofol</subject><subject>Prothrombin</subject><subject>Reaction time</subject><subject>Remifentanil</subject><subject>Statistical analysis</subject><subject>Sufentanil</subject><subject>sugammadex</subject><subject>Sugammadex - administration &amp; 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It is known to be highly efficient. However, a change in the coagulation profile is one of the most dangerous potential complications which is a concern for both surgeon and anesthetist. Bleeding may cause hypovolemic shock, hematoma, and so on. To investigate the effects of sugammadex on coagulation profiles in patients with thyroidectomy, we compared patients that were treated with either sugammadex or neostigmine. Eighty patients with thyroid neoplasms undergoing thyroidectomy were randomly allocated to sugammadex group (group S) or neostigmine group (group N). Induction of anesthesia was preformed using propofol, sufentanil, and rocuronium. Group S received sugammadex 2.0mg/kg after trachea intubation, similarly Group N received neostigmine 40 µg/kg, for reversal of rocuronium-induced neuromuscular blockade. The intraoperative coagulation profiles were monitored after the rocuronium injection (T0), 10 minutes after reversal (T1) and 30 minutes after reversal (T2) by testing activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (FIB), thrombin time (TT), and TEG-Haemonetics. Amount of bleeding was recorded during perioperative period. There was no significant difference in the thromboelastogram, APTT, PT, FIB, or TT measurements at each time point in Group N. The reaction time (R time) and kinetics time (K time) of Group S in T1 were significantly longer than the corresponding times at T0 and T2, and the R times were significantly longer than those in Group N at the same time points (P&lt;0.05). Additionally, in Group S, the APTT was prolonged in T1 and returned to normal in T2. 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ispartof Drug design, development and therapy, 2021-01, Vol.15, p.829-834
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1177-8881
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source Taylor & Francis Open Access; Publicly Available Content Database; PubMed Central
subjects Adolescent
Adult
Aged
Anesthesia
Bleeding
Blood
Blood coagulation factors
Blood Coagulation Tests
Clinical Trial Report
Coagulation
Comparative analysis
Complications
Drug dosages
Female
Fibrin
Fibrinogen
Heart rate
Hematoma
Humans
Intubation
Male
Medical examination
Middle Aged
Neoplasms
Neostigmine
Neostigmine - administration & dosage
Neostigmine - therapeutic use
Neuromuscular Blockade
Neuromuscular blocking agents
Patients
Propofol
Prothrombin
Reaction time
Remifentanil
Statistical analysis
Sufentanil
sugammadex
Sugammadex - administration & dosage
Sugammadex - therapeutic use
Surgeons
teg-haemonetics
Thrombin
Thromboplastin
Thyroid
Thyroid Neoplasms - drug therapy
Thyroid Neoplasms - surgery
Thyroidectomy
Trachea
Values
Young Adult
title Effects of Sugammadex versus Neostigmine on Intraoperative Coagulation Profiles in Patients with Thyroidectomy
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