Study of Rocuronium–Sugammadex as an Alternative to Succinylcholine–Cisatracurium in Microlaryngeal Surgery

Aragón-Benedí, C. ; Visiedo-Sánchez, S. ; Pascual-Bellosta, A. (Universidad de Zaragoza) ; Ortega-Lucea, S. (Universidad de Zaragoza) ; Fernández-Liesa, R. (Universidad de Zaragoza) ; Martínez-Ubieto, J. (Universidad de Zaragoza) ; Jiménez Bernardó, María Teresa (Universidad de Zaragoza) ; Muñoz Rodríguez, Luis Alfonso (Universidad de Zaragoza) ; Gil Bona, Jesús (Universidad de Zaragoza)

Resumen: Microlaryngeal surgery (ML) is a short procedure that requires a deep neuromuscular blockade to provide optimum surgical conditions. Succinylcholine is a relaxant widely used but involves numerous complications. One valid alternative is rocuronium, with a specific antagonist, sugammadex. The primary objective was to assess the surgical conditions in ML according to the relaxant. The secondary objectives were to assess intubation conditions and intraoperative and immediate postoperative adverse events. Study Design: Prospective randomized study. Methods: This was a prospective study of patients scheduled for ML randomized into two groups according to relaxant. Neuromuscular blockade was recorded after administration and during ML surgery. Surgical conditions were assessed using the ML Rating Scale, intubation conditions, remifentanil doses, intraoperative complications, surgery time, emergence time, and complications in the postanesthesia care unit. Results: Two hundred five patients were included (rocuronium = 103, succinylcholine = 102). Train-of-four values were higher for rocuronium, though the otorhinolaryngology surgical conditions were significantly better in that group (rocuronium = 5.54 ± 1.39 points; succinylcholine = 9.13 ± 1.99 points). Intubation conditions were similar in both groups. Remifentanil doses were higher for succinylcholine (P <.001) (rocuronium = 0.102 ± 0.05 µg/kg/min; succinylcholine = 0.201 ± 0.05 µg/kg/min). There were no differences in the duration of surgery, but the time to awakening was significantly longer for succinylcholine (rocuronium = 3.82 ± 1.38 minutes, succinylcholine = 9.18 ± 2.04 minutes, P <.001). Conclusions: Rocuronium provides better surgical conditions and allows for the use of lower doses of remifentanil as compared to succinylcholine and cisatracurium in ML. This makes it possible to decrease the time to awakening and the complications associated with high doses of remifentanil. Level of Evidence: 1b Laryngoscope, 2020.

Idioma: Inglés

DOI: 10.1002/lary.28649

Año: 2021

Publicado en: Laryngoscope 131, 1 (2021), E212-E218
ISSN: 0023-852X

Factor impacto JCR: 2.97 (2021)

Categ. JCR: OTORHINOLARYNGOLOGY rank: 13 / 43 = 0.302 (2021) - Q2 - T1
Categ. JCR: MEDICINE, RESEARCH & EXPERIMENTAL rank: 99 / 139 = 0.712 (2021) - Q3 - T3

Factor impacto CITESCORE: 4.7 - Medicine (Q2)

Factor impacto SCIMAGO: 1.167 - Otorhinolaryngology (Q1)

Financiación: info:eu-repo/grantAgreement/ES/DGA-FEDER/B26-17D

Tipo y forma: Article (PostPrint)

Área (Departamento): Área Enfermería (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Otorrinolaringología (Dpto. Cirugía)
Área (Departamento): Área Cirugía (Dpto. Cirugía)