The influence of mild hypothermia on reversal of rocuronium-induced deep neuromuscular block with sugammadex

Hee Jong Lee, Kyo Sang Kim, Ji Seon Jeong, Kyunam Kim, Byeong Chan Lee

Research output: Contribution to journalArticle

Abstract

Background: Mild hypothermia may be frequently induced due to cool environments in the operating room. The study analyzed patient recovery time and response to sugammadex after a prolonged rocuronium-induced deep neuromuscular block (NMB) during mild hypothermia. Methods: Sixty patients were randomly (1:1) allocated to the mild hypothermia and normothermia groups, defined as having core temperatures between 34.5 - 35°C and 36.5 - 37°C, respectively. Patients received 0.6mg/kg of rocuronium, followed by 7 - 10μg/kg/min to maintain a deep NMB [post-tetanic count (PTC) 1-2]. After surgery, the deep NMB was reversed with sugammadex 4.0mg/kg. The primary end-point was the time until the train-of-four (TOF) ratio was 0.9. Results: The appropriate neuromuscular function (TOF ratio ≥ 0.9) was restored after sugammadex was administered, even after hypothermia. The length of recovery in the hypothermia patients [mean (SD), 171.1 (62.1) seconds (s)] was significantly slower compared with the normothermia patients [124.9 (59.2) s] (p = 0.005). There were no adverse effects from sugammadex. Conclusions: Sugammadex safely and securely reversed deep rocuronium-induced NMB during mild hypothermia. An additional 46s was required for recovery from a deep NMB in hypothermia patients. Based on the results, we think this prolonged recovery time is clinically acceptable. Trial registration: ClinicalTrials.gov Identifier: NCT01965067.

Original languageEnglish
Article number7
JournalBMC Anesthesiology
Volume15
Issue number1
DOIs
StatePublished - 2015 Jan 21

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Neuromuscular Blockade
Hypothermia
Operating Rooms
rocuronium
Sugammadex
Temperature

Keywords

  • Hypothermia
  • Neuromuscular blockade rocuronium
  • Sugammadex

Cite this

@article{a36fc6f58fdd4812ac4ecd03f154a24e,
title = "The influence of mild hypothermia on reversal of rocuronium-induced deep neuromuscular block with sugammadex",
abstract = "Background: Mild hypothermia may be frequently induced due to cool environments in the operating room. The study analyzed patient recovery time and response to sugammadex after a prolonged rocuronium-induced deep neuromuscular block (NMB) during mild hypothermia. Methods: Sixty patients were randomly (1:1) allocated to the mild hypothermia and normothermia groups, defined as having core temperatures between 34.5 - 35°C and 36.5 - 37°C, respectively. Patients received 0.6mg/kg of rocuronium, followed by 7 - 10μg/kg/min to maintain a deep NMB [post-tetanic count (PTC) 1-2]. After surgery, the deep NMB was reversed with sugammadex 4.0mg/kg. The primary end-point was the time until the train-of-four (TOF) ratio was 0.9. Results: The appropriate neuromuscular function (TOF ratio ≥ 0.9) was restored after sugammadex was administered, even after hypothermia. The length of recovery in the hypothermia patients [mean (SD), 171.1 (62.1) seconds (s)] was significantly slower compared with the normothermia patients [124.9 (59.2) s] (p = 0.005). There were no adverse effects from sugammadex. Conclusions: Sugammadex safely and securely reversed deep rocuronium-induced NMB during mild hypothermia. An additional 46s was required for recovery from a deep NMB in hypothermia patients. Based on the results, we think this prolonged recovery time is clinically acceptable. Trial registration: ClinicalTrials.gov Identifier: NCT01965067.",
keywords = "Hypothermia, Neuromuscular blockade rocuronium, Sugammadex",
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The influence of mild hypothermia on reversal of rocuronium-induced deep neuromuscular block with sugammadex. / Lee, Hee Jong; Kim, Kyo Sang; Jeong, Ji Seon; Kim, Kyunam; Lee, Byeong Chan.

In: BMC Anesthesiology, Vol. 15, No. 1, 7, 21.01.2015.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The influence of mild hypothermia on reversal of rocuronium-induced deep neuromuscular block with sugammadex

AU - Lee, Hee Jong

AU - Kim, Kyo Sang

AU - Jeong, Ji Seon

AU - Kim, Kyunam

AU - Lee, Byeong Chan

PY - 2015/1/21

Y1 - 2015/1/21

N2 - Background: Mild hypothermia may be frequently induced due to cool environments in the operating room. The study analyzed patient recovery time and response to sugammadex after a prolonged rocuronium-induced deep neuromuscular block (NMB) during mild hypothermia. Methods: Sixty patients were randomly (1:1) allocated to the mild hypothermia and normothermia groups, defined as having core temperatures between 34.5 - 35°C and 36.5 - 37°C, respectively. Patients received 0.6mg/kg of rocuronium, followed by 7 - 10μg/kg/min to maintain a deep NMB [post-tetanic count (PTC) 1-2]. After surgery, the deep NMB was reversed with sugammadex 4.0mg/kg. The primary end-point was the time until the train-of-four (TOF) ratio was 0.9. Results: The appropriate neuromuscular function (TOF ratio ≥ 0.9) was restored after sugammadex was administered, even after hypothermia. The length of recovery in the hypothermia patients [mean (SD), 171.1 (62.1) seconds (s)] was significantly slower compared with the normothermia patients [124.9 (59.2) s] (p = 0.005). There were no adverse effects from sugammadex. Conclusions: Sugammadex safely and securely reversed deep rocuronium-induced NMB during mild hypothermia. An additional 46s was required for recovery from a deep NMB in hypothermia patients. Based on the results, we think this prolonged recovery time is clinically acceptable. Trial registration: ClinicalTrials.gov Identifier: NCT01965067.

AB - Background: Mild hypothermia may be frequently induced due to cool environments in the operating room. The study analyzed patient recovery time and response to sugammadex after a prolonged rocuronium-induced deep neuromuscular block (NMB) during mild hypothermia. Methods: Sixty patients were randomly (1:1) allocated to the mild hypothermia and normothermia groups, defined as having core temperatures between 34.5 - 35°C and 36.5 - 37°C, respectively. Patients received 0.6mg/kg of rocuronium, followed by 7 - 10μg/kg/min to maintain a deep NMB [post-tetanic count (PTC) 1-2]. After surgery, the deep NMB was reversed with sugammadex 4.0mg/kg. The primary end-point was the time until the train-of-four (TOF) ratio was 0.9. Results: The appropriate neuromuscular function (TOF ratio ≥ 0.9) was restored after sugammadex was administered, even after hypothermia. The length of recovery in the hypothermia patients [mean (SD), 171.1 (62.1) seconds (s)] was significantly slower compared with the normothermia patients [124.9 (59.2) s] (p = 0.005). There were no adverse effects from sugammadex. Conclusions: Sugammadex safely and securely reversed deep rocuronium-induced NMB during mild hypothermia. An additional 46s was required for recovery from a deep NMB in hypothermia patients. Based on the results, we think this prolonged recovery time is clinically acceptable. Trial registration: ClinicalTrials.gov Identifier: NCT01965067.

KW - Hypothermia

KW - Neuromuscular blockade rocuronium

KW - Sugammadex

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U2 - 10.1186/1471-2253-15-7.

DO - 10.1186/1471-2253-15-7.

M3 - Article

VL - 15

JO - BMC Anesthesiology

JF - BMC Anesthesiology

SN - 1471-2253

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