Application of sugammadex in tracheal extubation under deep anesthesia in children undergoingadenoidectomy / 中国医师杂志

ABSTRACT

Objective:To compare the effects of deep anesthesia extubation with sugammadex and neostigmine on perioperative respiratory adverse events (PRAE) and the duration of anesthesia recovery room (PACU) in children undergoing adenoidectomy.Methods:The clinical data of 470 children with adenoidectomy who underwent deep anesthesia extubation from February 2021 to April 2022 in Shenzhen Hospital of Southern Medical University were retrospectively analyzed. According to the use of muscle relaxant, they were divided into sugammadex group (group S) and neostigmine group (group N). Group S was intravenously injected with sugammadex 2 mg/kg after operation, and group N was intravenously injected with neostigemine 0.05 mg/kg combined with atropine 0.02 mg/kg when the train-of-four (TOF) value was >25%. The extubation time and PACU residence time of the two groups were recorded. Changes of heart rate (HR) and mean arterial pressure (MAP) immediately after surgery (T 0), within 1min after extubation (T 1), 5 min after extubation (T 2), and 20 min after extubation (T 3). PRAE was record. Results:There were 138 cases of propensity score matching in group S and group N respectively. The extubation time and PACU residence time in group S were shorter than those in group N (all P<0.05). At T 1, T 2 and T 3, HR and MAP in group S were significantly lower than those in group N (all P<0.05). The incidence of persistent cough and decreased blood oxygen in group S was lower than that in group N (all P<0.05). Conclusions:Compared with neostigmine, postoperative deep anesthesia extubation with sugammadex antagonistic residual muscle relaxant can shorten the duration of extubation and PACU retention after adenoidectomy, accelerate the recovery of children, make the peri-extubation cycle more stable, and reduce the occurrence of PRAE.