Evaluation of Sugammadex Vs. Neostigmine in the PACU for Abdominal Surgeries
University of South Florida
Summary
Sugammadex was approved for post-operative use in the operating room (OR) and post-anesthesia recovery unit (PACU) of our quaternary facility, Tampa General Hospital. The approval came with administrative limitations: 2mg/kg dose only and for the first year its utilization was limited as replacement for up to half of Neostigmine/Glycopyrrolate use. An MUE evaluation was completed for a retrospective chart review from March 2017 to December 2017 (10 months) to assess all cases in which patients received Sugammadex or Neostigmine. During the year of data collection, we also noted a widespread tendency to reduce the usage of narcotics. A t-test comparison of the length of stay (LOS) in the PACU revealed a highly significant difference between the LOS in PACU for both drugs. On average, patients receiving Sugammadex were discharged from the PACU 43 minutes earlier than patients who received Neostigmine/Glycopyrrolate. The patient mix in both groups was similar, but these data were obtained retrospectively by a pharmacy chart review.
Description
Primary Objective: * To evaluate the Length of Stay (LOS) in the PACU after a neuromuscular reversal with Sugammadex in comparison with Neostigmine/Glycopyrrolate in abdominal surgeries (hernia, gallbladder, etc.). * Primary Endpoints: Date, Gender, Date of Procedure, Length of Procedure, Attending Anesthesiologist, Length of PACU stay (Admission and Discharge), Pain VAS score, Aldrete Score, Finger Saturation, and BP upon PACU discharge. Study Design This is a prospective, randomized, study to evaluate the length of stay in the PACU after a neuromuscular reversal with Sugammadex in comparis…
Eligibility
- Age range
- 18–65 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * 18-75 years of age * Patients with surgeries with duration of 90-120 minutes * ASA Patients I-III (Appendix A) * Patients admitted to TGH for abdominal hernia repair, cholecystectomy and/or abdominal surgery as performed by Dr. Albrink * BMI \> 30 Exclusion Criteria: * \<18 years of age * ASA Patients IV and above (Appendix A) * Patients with allergic reactions to Neostigmine+Glycopyrrolate and/or Sugammadex
Interventions
- DrugNeuromuscular Blocking Agents
Neuromuscular agents will be used to block muscle function for the safety and efficiency of the procedure. At the procedure's conclusion, neuromusclar agents such as Neostigmine or Sugammadex will be used to reverse the neuromuscular reversal.
Location
- Tampa General HospitalTampa, Florida