Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Gazi Üniversitesi, Tıp Fakültesi, Turkey
Approval Date: 2012
Student: FERAY GÜMÜŞ
Supervisor: ÖMER KURTİPEK
Abstract:We invended to show the effects of neostigmine and suggamadex on neuromusculer block by rocuronium with TOF monitorization of neuromusculer block. In this prospective, randomized, double blind trial, 60 consenting pediatric patients; ASA I-II and ages between 2-12 years; undergoing tonsillectomy/adenotonsillectomy surgery were enrolled. We have done of neuromusculer block with Watch SX and routine monitorization according to the guidelines of ASA. The patients were randomly divided into two group; Group N n=30 (neostigmine) and Group S n=30 (sugammadex). We used %8 sevoflurane and 0,6 mg.kg-1 rocuronium fort he induction of anesthesia. When the neuromusculer block was %100, endotracheal intubation was performed. The anesthesia maintained with 0,05-0,2µg.kg-1min-1 remifentanyl and %1-2 sevoflurane. Hemodynamics datas and TOF values of the patients were recorded. When TOF value was % 75 and if it s necessary to use rocuronium, rocuronium injection was done 0.15 mg.kg-1. During bleeding control, remifentanyl infusion was stopped by reducing its dose gradually and sevoflurane reduced to %1-0.8. At the end of the operation anesthetist used 2 mg.kg-1 sugammadex to Group S, 50µ.kg-1 neostigmin (0.4 mg atropin add to 1 mg neostigmine) to Group N. When TOF value was %90, extubation was done. Mean time of TOF extubation in the Group S was 96,8±20.8 sec. and 200±61.7 sec in Group N. The average time until TOF value %100 was found 219.4±60.7 sec in Group N and 96.8 ±20.8 sec in Group S. In our research, we observed that the time until TOF value %100 and extubation time is shorter in Group S than Group N. In the group, given neostigmine and atropin, we observed significant increases in heart beat and systolic arterial blood pressure. But there was no significant change in Group S. We conclude that, suggamadex 2 mg.kg-1 is a faster and effective agent than 50µg.kg-1 neostigmine fort he reverse of the block by a middle- effected neuromusculer agent (rocuronium) in pediatric patients who were applied tonsillectomy/adenotonsillectomy.