Abstract
Background & Objectives: Sugammadex is a novel neuromuscular reversal agent, and there are limited number of experience with usage of this agent for infant patient group in literature.1, 2 The objective of this study is to evaluate the efficacy and safety of sugammadex in reversing profound neuromuscular block induced by rocuronium in infant patients. Materials & Methods: This study was approved by Baskent University Institutional Review Board (Project no: KA16/67) and supported by Baskent University Research Fund. Twenty-six ASA I-III infant patients aged 2 to 12 months with a weight range of 3 to 11 kg were studied undergoing meningomyelosele repair, hydrocephalus and spinal fusion surgery with general anesthesia. Anaesthesia was induced with 5 mg/kg thiopental, 1µg/kg fentanil and 0.6 mg/kg rocuronium. Sevoflurane was administered to all patients after intubation.The neuromuscular block was monitored with acceleromyography using TOF stimuli. At the end of surgery, sevoflurane inhalation was interrupted and switched to 100% O2 and TOF monitorization began. If profound neuromuscular block (TOF= 0) persisted at the end of the surgery, 3 mg /kg sugammadex was administered intravenously to evaluate their neurological status at early postoperative period. Results: Our study included a total of 26 patients, of which 10 were male and 16 were female. The mean age of the patients was 6.15 ± 3.52 (2-12) months and their mean weight was7.11 ± 2.33 (3-11) kg. The operative time was found 65.38 ± 24.40 (30-120) minutes and the mean recovery time of the T4/T1 ratio to 0.9 was 112.65 ± 35.60 (60-240) seconds. We did not encounter any complication at extübation period like bradycardia, tachycardia, laringospasm, broncospasm. No clinical evidence of recurarization or residual curarization was observed. A limited number of complications were observed (3 patient for cough and 2 patient for agitation) after extubation. Complications such as nausea, vomiting, bradycardia, tashicardia, rush and hypersensitivity were not observed in any patient after extubation. Conclusion: The efficacy and safety of sugammadex were confirmed in infant surgical patients for reversal of deep neuromusculer block from rocuronium.
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