Study of Rocuronium-Sugammadex as an Alternative to Succinylcholine-Cisatracurium in Microlaryngeal Surgery.

Aragón‐Benedí, Cristian; Visiedo‐Sánchez, Sara; Pascual‐Bellosta, Ana; Ortega‐Lucea, Sonia; Fernández‐Liesa, Rafael; Martínez‐Ubieto, Javier; Aragón-Benedí, Cristian; Visiedo-Sánchez, Sara; Pascual-Bellosta, Ana; Ortega-Lucea, Sonia; Fernández-Liesa, Rafael; Martínez-Ubieto, Javier; Research Group in Anesthesia, Resuscitation AND Perioperative Medicine of Aragón Health Research Institute (IIS Aragón)

Microlaryngeal surgery (ML) is a short procedure that requires a deep neuromuscular blockade to provide optimum surgical conditions. Succinylcholine is a relaxant widely used but involves numerous complications. One valid alternative is rocuronium, with a specific antagonist, sugammadex. The primary objective was to assess the surgical conditions in ML according to the relaxant. The secondary objectives were to assess intubation conditions and intraoperative and immediate postoperative adverse events.Study Design: Prospective randomized study.Methods: This was a prospective study of patients scheduled for ML randomized into two groups according to relaxant. Neuromuscular blockade was recorded after administration and during ML surgery. Surgical conditions were assessed using the ML Rating Scale, intubation conditions, remifentanil doses, intraoperative complications, surgery time, emergence time, and complications in the postanesthesia care unit.Results: Two hundred five patients were included (rocuronium = 103, succinylcholine = 102). Train-of-four values were higher for rocuronium, though the otorhinolaryngology surgical conditions were significantly better in that group (rocuronium = 5.54 ± 1.39 points; succinylcholine = 9.13 ± 1.99 points). Intubation conditions were similar in both groups. Remifentanil doses were higher for succinylcholine (P Conclusions: Rocuronium provides better surgical conditions and allows for the use of lower doses of remifentanil as compared to succinylcholine and cisatracurium in ML. This makes it possible to decrease the time to awakening and the complications associated with high doses of remifentanil.Level Of Evidence: 1b Laryngoscope, 131:E212-E218, 2021.

NEUROMUSCULAR blockade; SUGAMMADEX; ROCURONIUM bromide; EXPERIMENTAL design; SURGICAL complications; LARYNGEAL surgery; SUCCINYLCHOLINE; RESEARCH; NEUROMUSCULAR depolarizing agents; COMBINATION drug therapy; OPERATIVE surgery; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; RANDOMIZED controlled trials; CURARE-like agents; LARYNGEAL diseases; BLIND experiment; RESEARCH funding; ATRACURIUM; LONGITUDINAL method

Laryngoscope, 2021, Vol 131, Issue 1, pE212

0023-852X

Academic Journal

10.1002/lary.28649