Sugammadex versus neostigmina en la reversión de la relajación neuromuscular en neurocirugía. Experimento clínico. Reporte preliminar
| Contribuinte(s) |
Montes, Felix Ramon |
|---|---|
| Data(s) |
09/08/2013
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| Resumo |
Existen grupos quirúrgicos específicos donde es mandatorio el uso de relajantes neuromusculares no despolarizantes, como es el caso de los pacientes llevados a procedimiento de neurocirugía; debido a sus características particulares el rocuronio es una buena alternativa para este tipo de procedimientos, ya sea en bolos o en infusión. Sin embargo la relajación residual y los efectos adversos de los medicamentos para revertir la relajación neuromuscular deben tenerse en cuenta en este grupo de pacientes en particular. El presente trabajo busca comparar la reversión de la relajación de infusiones de rocuronio, con Neostigmina mas Atropina vs la reversión con Sugammadex en pacientes llevados a manejo quirúrgico de lesiones supratentoriales por parte del servicio de neurocirugía de la Fundación Cardioinfantil, evaluando complicaciones durante la administración de los medicamentos y 24 horas posoperatorias, así como los tiempos para extubación y salida de salas de cirugía. Estudio con características de experimento prospectivo, aleatorizado, ciego, controlado. En este documento se realiza un reporte preliminar descriptivo de 14 pacientes reclutados hasta la actualidad. Fundación Cardioinfantil There are specific surgical groups where it is mandatory the use of non-depolarizing neuromuscular relaxants, as is the case of patients undergoing neurosurgical procedures, due to its particular characteristics rocuronium is a good alternative to these procedures, either by bolus or infusion. However, the residual relaxation and adverse effects of drugs for reversing neuromuscular relaxation should be taken into account in this particular patient group. This paper seeks to compare the reversal of rocuronium infusions relaxation with neostigmine / atropine vs reversal with sugammadex in patients undergoing surgical management of supratentorial lesions from the neurosurgery service in Cardioinfantil Foundation, evaluating complications during the administration of drugs and 24 hours postoperative, extubation times, and out of operating rooms. Prospective experiment, randomized, blinded, controlled. This paper takes a preliminary report of 14 patients recruited until now |
| Formato |
application/pdf |
| Identificador | |
| Idioma(s) |
spa |
| Publicador |
Facultad de Medicina |
| Direitos |
info:eu-repo/semantics/openAccess |
| Fonte |
instname:Universidad del Rosario reponame:Repositorio Institucional EdocUR Calvey TN, Williams NE, Principles and Practice Pharmacology for Anaesthetists. Blackwell Publishing 2008. Bock M, Klippel K, Nitsche B, Bach A y cols.. Rocuronium potency and recovery characteristics during steady-state desflurane, sevoflurane, isoflurane or propofol anaesthesia. Br J Anaesth 2000;84:43-7 Maidatsi PG, Zaralidou AT, Gorgias NK, Amaniti EN y cols. Rocuronium duration of action under sevoflurane, desflurane or propofol anaesthesia. Eur J Anaesthesiol 2004;21:781-6. Robertson EN, Driessen JJ, Booij LH. Pharmacokinetics and pharmacodynamics of rocuronium in patients with and without renal failure. Eur J Anaesthesiol 2005;22:4-10 van Miert MM, Eastwood NB, Boyd AH, Parker CJ y cols. The pharmacokinetics and pharmacodynamics of rocuronium in patients with hepatic cirrhosis. Br J Clin Pharmacol 1997;44:139-44 Yang L, Wang HL, Zhang LP, Bi SS y Colaboradores. Population pharmacokinetics of rocuronium delivered by target-controlled infusion in adult patients. Chin Med J (Engl) 2010;123:2543-7 Jellish WS, Brody M, Sawicki K, Slogoff S. Recovery from neuromuscular blockade after either bolus and prolonged infusions of cisatracurium or rocuronium using either isoflurane or propofol-based anesthetics. Anesth Analg 2000; 91:1250-5 Loan PB, Connolly FM, Mirakhur RK, Kumar N. Neuromuscular effects of rocuronium in patients receiving beta-adrenoreceptor blocking, calcium entry blocking and anticonvulsant drugs. Br J Anaesth 1997; 78:90-1 Hernández-Palazón J, Tortosa JA, Martínez-Lage JF, Pérez-Ayala M. Rocuronium induced neuromuscular blockade is affected by chronic phenytoin therapy. J Neurosurg Anesthesiol 2001;13:79-82 Srivastava A, Hunter JM. Reversal of neuromuscular block. Br J Anaesth 2009;103:115-29 Kirkegaard-Nielsen H, Helbo-Hansen HS, Lindholm P, Severinsen IK. Optimum time for neostigmine reversal of atracurium-induced neuromuscular blockade. Can J Anaesth 1996;43:932-8 Miller RD, Van Nyhuis LS, Eger EI 2nd, Vitez TS y cols. Comparative times to peak effect and durations of action of neostigmine and pyridostigmine. Anesthesiology 1974;41:27-33 Husain MA, Roberts JB, Thomas BH, Wilson A. Metabolism and exretion of 3-hydroxyphenyltrimethylammonium and neostigmine. Br J Pharmacol 1969;35:344-50 Williams NE, Calvey TN, Chan K. Clearance of neostigmine from the circulation during the antagonism of neuromuscular block. Br J Anaesth 1978;50:1065-7 Bevan DR, Smith CE, Donati F. Postoperative neuromuscular blockade: a comparison between atracurium, vecuronium, and pancuronium. Anesthesiology 1988;69:272-6 Bevan JC, Collins L, Fowler C, Kahwaji R y Colaboradores. Early and late reversal of rocuronium and vecuronium with neostigmine in adults and children. Anesth Analg 1999;89:333-9 Bevan JC, Tousignant C, Stephenson C, Blackman L. Dose responses for neostigmine and edrophonium as antagonists of mivacurium in adults and children. Anesthesiology 1996;84:354-61 Akha AS, Rosa J 3rd, Jahr JS, Li A. Sugammadex: cyclodextrins, development of selective binding agents, pharmacology, clinical development, and future directions. Anesthesiol Clin 2010;28:691-708 Ren WH, Jahr JS. Reversal of neuromuscular block with a selective relaxant- binding agent: sugammadex. Am J Ther 2009;16:295-9 Naguib M. Sugammadex: another milestone in clinical neuromuscular pharmacology. Anesth Analg 2007;104:575-81 Nicholson WT, Sprung J, Jankowski CJ. Sugammadex: a novel agent for the reversal of neuromuscular blockade. Pharmacotherapy 2007; 27:1181-8 Sorgenfrei IF, Norrild K, Larsen PB, Stensballe J y Colaboradores. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study. Anesthesiology 2006;104:667-74 Jones RK, Caldwell JE, Brull SJ, Soto RG. Reversal of profound rocuronium-induced blockade with sugammadex: a randomized comparison with neostigmine. Anesthesiology 2008;109:816-24 Pühringer FK, Rex C, Sielenkämper AW, Claudius C y cols. Reversal of profound, high-dose rocuronium-induced neuromuscular blockade by sugammadex at two different time points: an international, multicenter, randomized, dose-finding, safety assessor-blinded, phase II trial. Anesthesiology 2008;109:188-97 Rex C, Wagner S, Spies C, Scholz J. Reversal of neuromuscular blockade by sugammadex after continuous infusion of rocuronium in patients randomized to sevoflurane or propofol maintenance anesthesia. Anesthesiology 2009;111:30-5 Staals LM, Snoeck MM, Driessen JJ, van Hamersvelt HW y cols. Reduced clearance of rocuronium and sugammadex in patients with severe to end-stage renal failure: a pharmacokinetic study. Br J Anaesth 2010;104:31-9 Sacan O, White PF, Tufanogullari B, Klein K. Sugammadex reversal of rocuronium-induced neuromuscular blockade: a comparison with neostigmine-glycopyrrolate and edrophonium-atropine. Anesth Analg 2007;104:569-74 Fuchs-Buder T, Claudius C, Skovgaard LT, Eriksson LI, Mirakhur RK, Viby-Mogensen J; 8th International Neuromuscular Meeting. Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision. Acta Anaesthesiol Scand 2007;51:789-808 |
| Palavras-Chave | #NEOSTIGMINA - UTILIZACIÓN #NEUROCIRUGÍA - INVESTIGACIONES #RELAJANTES MUSCULARES NO DESPOLARIZANTES #SUGAMMADEX - UTILIZACIÓN #sugammadex #neostigmine #atropine #rocuronium |
| Tipo |
info:eu-repo/semantics/bachelorThesis info:eu-repo/semantics/acceptedVersion |
