Medicine (Baltimore). 2025 May 16;104(20):e42385. doi: 10.1097/MD.0000000000042385.
ABSTRACT
BACKGROUND: Sugammadex sodium can antagonize aminosteroidal muscarinic drugs precisely and rapidly, so it has been widely used in fast-track anesthesia in recent years. However, it is not known whether there is an advantage of the antagonistic effect of sugammadex sodium over neostigmine at different doses and time points. In this single-center, randomized controlled study, we compared the effects of sugammadex sodium with neostigmine on postoperative myorelaxation recovery in patients undergoing suspension laryngoscopic surgery.
METHODS: A total of 90 patients scheduled for elective general anesthesia suspension laryngoscopy were selected, aged 18 to 65 years, body mass index 18 to 28 kg/m², and American Society of Anesthesiologists I-II grade. Patients were randomly divided into 3 groups: the sugammadex group (experimental groups, S1, S2), and the neostigmine group (control group, N), each comprising 30 patients. After the operation, group S1 received an intravenous injection of sugammadex sodium 2 mg/kg immediately, S2 received it when train-of-four COUNT (TOF-COUNT) > 2, and group N received intravenous injections of atropine 0.02 mg/kg + neostigmine 0.04 mg/kg when TOF-COUNT > 2. The mean arterial pressure, heart rate, pulse oxygen saturation, and bispectral index were recorded at various times: upon room entry (T1), during tracheal intubation (T2), at surgery start (T3), surgery end (T4), at extubation (T5), and upon room exit (T6). The duration of surgery, muscle relaxation recovery time from TOF-COUNT 0-2 at surgery end, and time from surgery end to extubation were recorded for each group, as well as the incidence of adverse reactions.
RESULTS: There were no statistically significant differences among the 3 groups in mean arterial pressure, heart rate, pulse oxygen saturation, and bispectral index at the 6 time points (T1, T2, T3, T4, T5, and T6). In terms of extubation timing, the S1 group showed a significantly shorter time compared with the S2 and N groups (P < .05). Compared with the S2 group, N group had significantly prolonged extubation times, showing a statistical difference. Compared with the N group, S1 and S2 groups had a significantly reduced incidence of bradycardia and increased secretions (P < .05).
CONCLUSION: The use of sugammadex sodium in otolaryngological suspension laryngoscopy surgeries offers certain advantages over neostigmine in terms of muscle relaxation recovery. Administering sugammadex sodium 2 mg/kg directly after surgery as compared with waiting until TOF-COUNT > 2 allows for earlier removal of the tracheal tube without increasing adverse reactions.
PMID:40388779 | DOI:10.1097/MD.0000000000042385
