舒更葡糖钠与新斯的明拮抗肾移植术患者罗库溴铵残余肌松效果的比较:大样本、回顾性研究

Sugammadex versus neostigmine for reversal of rocuronium-induced residual neuromuscular blockade in patients undergoing renal transplantation:a large-scale,retrospective study

目的比较舒更葡糖钠与新斯的明拮抗肾移植术患者罗库溴铵残余肌松的效果。方法回顾性分析2018年1月至2020年12月本院心脏死亡器官捐献肾移植术患者临床资料,根据肌松拮抗剂使用情况分为舒更葡糖钠组(S组)及新斯的明组(N组)。记录肌松拮抗起效时间、气管拔管时间及PACU停留时间。于术前、术后第1、3、5、7天记录肌酐清除率。记录术后并发症发生情况。结果共纳入603例患者,S组278例、N组325例。与N组比较,S组肌松拮抗起效时间、气管拔管时间及PACU停留时间明显缩短,术后24 h内低氧血症及术后7 d内新发肺部感染发生率明显降低(P<0.05),各时点肌酐清除率比较差异无统计学意义,术后心血管并发症、移植物并发症发生率差异无统计学意义(P>0.05)。结论与新斯的明相比,舒更葡糖钠能更快速拮抗肾移植术患者罗库溴铵残余肌松,有利于早期恢复,且安全性较高。

Objective To compare the efficacy of sugammadex versus neostigmine on reversal of rocuronium-induced residual neuromuscular blockade in patients undergoing renal transplantation.Methods The clinical data of patients undergoing kidney transplantation from donation after cardiac death in our hospital from January 2018 to December 2020 were retrospectively analyzed.Patients were divided into sugammadex group(group S)and neostigmine group(group N)according to the use of muscle relaxant antagonists.The onset time of antagonism,time of tracheal extubation,and time of postanesthesia care unit stay were recorded.The creatinine clearance rate was recorded before operation and at 1,3,5 and 7 days after operation.The occurrence of postoperative complications was recorded.Results A total of 603 patients were enrolled in this study,with 278 patients in group S and 325 patients in group N.Compared with group N,the onset time of antagonism,time of extubation,and time of postanesthesia care unit stay were significantly shortened,the incidence of hypoxemia within 24 h after surgery and pulmonary infection occurred within 7 days after surgery was decreased(P<0.05),and no significant change was found in the creatinine clearance rate at each time point and incidence of postoperative cardiovascular complications and graft complications in group S(P>0.05).Conclusion Compared with neostigmine,sugammadex can reverse rocuronium-induced residual neuromuscular blockade more quickly,which is helpful for early recovery with a higher safety when applied in the patients undergoing renal transplantation.