Capnography Monitoring to Reduce Adverse Events in the Pediatric Post-Anesthesia Care Unit

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 189A-189A
Author(s):  
Melissa L. Langhan ◽  
Fangyong Li ◽  
Lance Lichtor
Keyword(s):  
Adverse Events ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit

Post-operative respiratory outcomes associated with the use of sugammadex in laparoscopic colorectal cancer surgery: a retrospective, propensity score matched cohort study

2020 ◽  
Keyword(s):  
Colorectal Surgery ◽  
Propensity Score ◽  
Adverse Events ◽  
Propensity Score Matching ◽  
Neuromuscular Blockade ◽  
Laparoscopic Colorectal Surgery ◽  
Anesthesia Care ◽  
Care Hospital ◽  
Post Anesthesia Care Unit ◽  
Clinical Benefits

Sugammadex can rapidly reverse neuromuscular blockade and has several advantages over cholinesterase inhibitors. It is unclear, however, whether administration of sugammadex in the absence of intraoperative deep neuromuscular blockade has direct clinical benefits. The present study retrospectively assessed the ability of sugammadex to prevent post-operative respiratory adverse events in patients undergoing laparoscopic colorectal surgery in the absence of routine deep neuromuscular blockade. The medical records of patients who underwent laparoscopic colorectal surgery from 2014 to 2018 in a tertiary care hospital were reviewed. Patients who underwent reversal of neuromuscular blockade with sugammadex or pyridostigmine were subjected to propensity score matching. To assess their relative effects on post-operative adverse respiratory events (defined as a composite of SpO2 < 94% in the post-anesthesia care unit, additional oxygen supplementation during ward transfer or stay, and emergency use of sugammadex in the post-anesthesia care unit), the incidence of these effects was compared in propensity score matched groups of patients treated with sugammadex or pyridostigmine. Of the 602 patients, 210 remained in each group after propensity score matching. The incidence of post-operative respiratory adverse events did not differ significantly in the two groups. These findings suggest that the unrestricted administration of sugammadex not preceded by intra-operative deep neuromuscular blockade does not have clinical benefits, when compared with pyridostigmine, in preventing post-operative respiratory adverse events.

scholarly journals Effects of age on sugammadex reversal of neuromuscular blockade induced by rocuronium in Chinese children: a prospective pilot trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruidong Zhang ◽  
Jie Hu ◽  
Shengde Li ◽  
Bin Xue ◽  
Lu Wang ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Adverse Events ◽  
Neuromuscular Blockade ◽  
Pilot Trial ◽  
Chinese Children ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Clinical Trial Registry ◽  
Extubation Time ◽  
Neuromuscular Blockade Reversal

Abstract Background Sugammadex reverses neuromuscular blockade induced by steroidal relaxants. We compared the recovery for neuromuscular blockade reversal with sugammadex in children aged 1–12 years. Methods From August 2019 to August 2020, patients who received 2.0 mg·kg− 1 sugammadex for neuromuscular blockade reversal after surgery were recruited. The primary outcome was the time for the train-of-four ratio (TOFR) to recover to 0.9; secondary outcomes included the incidence of the TOFR < 0.9, extubation time, length of stay at the post-anesthesia care unit, and adverse events. Hemodynamic parameters before and 5 min after sugammadex administration and vital signs in the recovery room were also recorded. Results Eighty-six children were recruited (1 to < 3 years, n = 23; 3 to < 5 years, n = 33; 5 to ≤12 years, n = 30). Intergroup differences in the recovery of the TOFR to 0.9 were not statistically significant (F = 0.691, p = 0.504). Recurrence of the TOFR < 0.9 was not observed in any group. Five minutes after sugammadex administration, the heart rates of patients aged 3 to < 5 and 5 to ≤12 years were significantly lower than those at baseline (p < 0.05). Extubation time was similar in patients aged 1 to ≤12 years. Length of stay and end-tidal capnography at the post-anesthesia care unit as well as adverse events did not differ significantly. Conclusion A moderate (TOF count two) rocuronium-induced neuromuscular blockade can be effectively and similarly reversed with sugammadex 2 mg·kg− 1 in Chinese children aged 1–12 years. Trial registration Chinese Clinical Trial Registry: ChiCTR1900023715 (June 8, 2019).

scholarly journals Effects of pre-emptive pregabalin and multimodal anesthesia on postoperative opioid requirements in patients undergoing robot-assisted laparoscopic prostatectomy

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
K. Sisa ◽  
S. Huoponen ◽  
O. Ettala ◽  
H. Antila ◽  
T. I. Saari ◽  
...  
Keyword(s):  
Postoperative Nausea And Vomiting ◽  
Multimodal Analgesia ◽  
Opioid Consumption ◽  
Anesthesia Induction ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Robot Assisted ◽  
Ctrl Group ◽  
Laparoscopic Prostatectomy ◽  
The Impact

Abstract Background Previous findings indicate that pre-emptive pregabalin as part of multimodal anesthesia reduces opioid requirements compared to conventional anesthesia in patients undergoing robot-assisted laparoscopic prostatectomy (RALP). However, recent studies show contradictory evidence suggesting that pregabalin does not reduce postoperative pain or opioid consumption after surgeries. We conducted a register-based analysis on RALP patients treated over a 5-year period to evaluate postoperative opioid consumption between two multimodal anesthesia protocols. Methods We retrospectively evaluated patients undergoing RALP between years 2015 and 2019. Patients with American Society of Anesthesiologists status 1–3, age between 30 and 80 years and treated with standard multimodal anesthesia were included in the study. Pregabalin (PG) group received 150 mg of oral pregabalin as premedication before anesthesia induction, while the control (CTRL) group was treated conventionally. Postoperative opioid requirements were calculated as intravenous morphine equivalent doses for both groups. The impact of pregabalin on postoperative nausea and vomiting (PONV), and length of stay (LOS) was evaluated. Results We included 245 patients in the PG group and 103 in the CTRL group. Median (IQR) opioid consumption over 24 postoperative hours was 15 (8–24) and 17 (8–25) mg in PG and CTRL groups (p = 0.44). We found no difference in postoperative opioid requirement between the two groups in post anesthesia care unit, or within 12 h postoperatively (p = 0.16; p = 0.09). The length of post anesthesia care unit stay was same in each group and there was no difference in PONV Similarly, median postoperative LOS was 31 h in both groups. Conclusion Patients undergoing RALP and receiving multimodal analgesia do not need significant amount of opioids postoperatively and can be discharged soon after the procedure. Pre-emptive administration of oral pregabalin does not reduce postoperative opioid consumption, PONV or LOS in these patients.

Analysis Of Post Operative Nausea And Vomiting In The Post Anesthesia Care Unit

2016 ◽  
Vol 31 (4) ◽  
pp. e59-e60
Author(s):  
Alison Partridge ◽  
Suzanne Hunnicutt ◽  
Carol Walker ◽  
Christina Crook ◽  
Shelley Stinson ◽  
...  
Keyword(s):  
Nausea And Vomiting ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Post Operative Nausea
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