A Study Of Small Dose Sugammadex Combined With Neostigmine For Reversal Of Rocuronium-induced Neuromuscular Blockade

Objective This study is intended to investigate the recovery of anesthesia after surgery and the effects of clinically recommended doses of sugammadex compared with small dose sugammadex combined with neostigmine for reversal neuromuscular blockade caused by rocuronium.Through this research,it is expected to make patients wake up from anesthesia more quickly,and provide reference for improving the clinical application of the combination.Methods The study method adopted a randomized block design method.According to the inclusion criteria and rejection criteria,60 patients who underwent elective colorectal surgery were enrolled in our hospital from July to February 2019.The patients were divided into 4 groups: N group(neostigmine 50 ug/kg,atropine 15 ug/kg);NS2 group(sugammadex 0.5 mg/kg,neostigmine 50 ug/kg,atropine 15ug/kg);NS1 group(sugammadex 1 mg/kg,neostigmine 50 ug/kg,atropine 15 ug/kg);group S(sugammadex 2 mg/kg);Electrocardiogram(ECG),blood pressure(BP),heart rate(HR),and peripheral oxygen saturation(Sp O2)were routinely monitored after admission to the operating room.After inducing sufentanil 0.4 ?g/kg and propofol 1-2 mg/kg,using TOF-WATCH muscle relaxer calibration,inject rocuronium 0.9 mg/kg,and then waiting for train of four stimulation(TOFC)is 0,the tracheal intubation was performed,and the position of the catheter was confirmed to be in place,and the anesthesia machine was connected to mechanical ventilation.Intraoperative intravenous injection of remifentanil 0.1-0.2 ?g/(kg·min),sevoflurane 1-3 %,maintaining anesthesia sevoflurane MAC 0.8-1.3%;intermittent addition of rocuronium 0.1-0.2 mg/kg,TOF was maintained at 0 during surgery to maintain surgical needs.The control breathing parameters were set to a ventilating tidal volume of 6-8 ml/kg,a respiratory rate of 10-14 times/min,an aspiration ratio of 1:2,and an inhaled oxygen concentration of 40%.When the surgery is finished,the anesthetic is stopped,and the patient is allowed to reversal and the TOFC is 2,the antagonist is administered.After administration,continuous observation and recording of four pairs of stimulation ratio TOF ratio recovery,mean arterial pressure(MAP),heart rate(HR)changes,electrocardiogram(TEG)changes postoperative adverse reactions etc.Results There were no significant differences in the age,gender,body mass index,ASA classification,and anesthesia parameters between four groups(P>0.05).Four groups of neuromuscular block from the TOFC 2 to TOFr is equal to 0.9,the S group is 140.8±26.93 s,the NS1 group is 413.46±162.07 s,the NS2 group is 443.73±213.87 s,the N group is 605.71±213.61 s.There was no significant difference between the NS1 group and the NS2 group.There were no clinical events related to residual neuromuscular block and re-blocking between four groups.Compared with four groups,the N group was more likely to have a faster or slower heart rate change than the S group.Conclusions In the effect of reversal of rocuronium-induced neuromuscular blockade,the use of sufficient sugammadex has a better clinical effect,and its effect is better than the use of small doses sugammadex combine neostigmine.