Comparison of sugammadex and pyridostigmine bromide for reversal of rocuronium-induced neuromuscular blockade in short-term pediatric surgery: A prospective randomized study

• Published in: Medicine (Baltimore) 2020-02, Vol.99 (7), p.e19130-e19130
• Main Authors: An, Jihyun, Lee, Ji-Hyang, Kim, Eunju, Woo, Kyeongyoon, Kim, Hyunkyum, Lee, Donghwan
• Format: Article
• Language: English
• Subjects: Child; Child, Preschool; Cholinesterase Inhibitors - administration & dosage; Cholinesterase Inhibitors - pharmacology; Clinical Trial/Experimental Study; Female; Humans; Infant; Male; Neuromuscular Blockade; Neuromuscular Nondepolarizing Agents - antagonists & inhibitors; Prospective Studies; Pyridostigmine Bromide - administration & dosage; Pyridostigmine Bromide - pharmacology; Random Allocation; Rocuronium - antagonists & inhibitors; Single-Blind Method; Sugammadex - administration & dosage; Sugammadex - pharmacology; Time Factors
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000019130

Sugammadex reverses rocuronium-induced neuromuscular blockade quickly and effectively. This study compared efficacy of sugammadex and pyridostigmine for reversal of rocuronium-induced light block or minimal block in children scheduled for elective entropion surgery. A prospective randomized study was conducted on 60 pediatric patients aged 1 to 11 years and scheduled for entropion surgery under sevoflurane anesthesia. Neuromuscular blockade was achieved by administration of 0.6 mg/kg rocuronium and assessed using train-of-four (TOF) ulnar nerve stimulation. Patients were randomly assigned to 2 groups receiving sugammadex 2 mg/kg or pyridostigmine 0.2 mg/kg plus glycopyrrolate 0.01 mg/kg. Primary outcomes were time from reversal agents administration to TOF ratio 0.9 and time from reversal agent administration to TOF ratio 1.0. Time from TOF ratio 0.9 to extubation, time from TOF ratio 1.0 to extubation, and postoperative adverse events were also recorded. There were no substantial differences in demographic variables. Time from reversal agents administration to TOF ratio 0.9 and time from reversal agents to TOF ratio 1.0 were significantly faster in sugammadex group: 1.30 ± 0.84 versus 3.53 ± 2.73 minutes (P