• Cristian Deana, Federico Barbariol, Stefano D'Incà, Livia Pompei, and Giorgio Della Rocca.
• Anesthesia and Intensive Care 1, Department of Anesthesia and Intensive Care Medicine, Academic Hospital "S. Maria della Misericordia", Piazzale S. M. della Misericordia, 15, 33100, Udine, Italy. deana.cristian@gmail.com.
• BMC Anesthesiol. 2020 Mar 25; 20 (1): 7070.

BackgroundRapid neuromuscular block reversal at the end of major abdominal surgery is recommended to avoid any postoperative residual block. To date, no study has evaluated sugammadex performance after rocuronium administration in patients undergoing liver transplantation. This is a randomized controlled trial with the primary objective of assessing the neuromuscular transmission recovery time obtained with sugammadex versus neostigmine after rocuronium induced neuromuscular blockade in patients undergoing orthotopic liver transplantation.MethodsThe TOF-Watch SX®, calibrated and linked to a portable computer equipped with TOF-Watch SX Monitor Software®, was used to monitor and record intraoperative neuromuscular block maintained with a continuous infusion of rocuronium. Anaesthetic management was standardized as per our institution's internal protocol. At the end of surgery, neuromuscular moderate block reversal was obtained by administration of 2 mg/kg of sugammadex or 50 mcg/kg of neostigmine (plus 10 mcg/kg of atropine).ResultsData from 41 patients undergoing liver transplantation were analysed. In this population, recovery from neuromuscular block was faster following sugammadex administration than neostigmine administration, with mean times±SD of 9.4 ± 4.6 min and 34.6 ± 24.9 min, respectively (p < 0.0001).ConclusionSugammadex is able to reverse neuromuscular block maintained by rocuronium continuous infusion in patients undergoing liver transplantation. The mean reversal time obtained with sugammadex was significantly faster than that for neostigmine. It is important to note that the sugammadex recovery time in this population was found to be considerably longer than in other surgical settings, and should be considered in clinical practice.Trial RegistrationClinicalTrials.govNCT02697929 (registered 3rd March 2016).

20 keywords...

hide…