The Role of Sugammadex in Residual Myoplegia Control in Fast Track Extubation Protocol of Patients after Operations with Cardiopulmonary Bypass
The aim of the investigation was clinical assessment of sugammadex (Bridan) use efficiency for early activization of patients after open-heart operations with cardiopulmonary bypass.
Materials and Methods. We analyzed the results of sugammadex (Bridan) treatment of 30 patients after open-heart operations under cardiopulmonary bypass. Among them there were 17 male and 13 female aged from 25 to 62 years (mean age 49.4±5.3 years). Cardiopulmonary bypass time was from 50 to 129 min (mean time 78.9±10.4 min), aortic compression time — from 38 to 111 min (mean time 62.1±8.2 min). We studied clinical progression of postperfusion period, acid-base composition and blood gases, the change of central hemodynamics indices and TOF index (neuromuscular conduction index). Total dose of the administered drug was 4.3–6.9 mg/kg.
Results. The recovery of a good muscle tone and autonomous breathing was observed immediately after the drug injection in 29 patients (96.7%). TOF index (neuromuscular conduction index) increased from 0.23±0.03 to 0.92±0.01 (p≤0.05) within 3–5 min after the drug administration. The drug had no effect on the changes of central hemodynamics indices, contributed to rapid and full recovery of muscle tone and autonomous breathing in patients. Extubation was performed in operating room, and activization time was 30–120 min (on average 47.0±10.4 min). 27 patients (90.0%) stayed in the intensive care unit (ICU) for 18 h on average, three patients stayed in ICU for 2 days due to the continuous cardiac pacing. The complication resulted from sugammadex usage was delayed vomiting (40–50 min after the drug administration) in 3 patients.
Conclusion. The use of sugammadex (Bridan) for fast track extubation protocol of patients after cardiosurgical interventions with cardiopulmonary bypass is feasible and very efficient.
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