SUGAMMADEX VERSUS NEOSTIGMINE FOR REVERSAL OF NEUROMUSCULAR BLOCKADE AND PREVENTION OF RESPIRATORY ADVERSE EVENTS FOLLOWING FUNCTIONAL ENDOSCOPIC SINUS SURGERY: A RANDOMIZED DOUBLE-BLIND STUDY

Abstract

Objective

To compare perioperative respiratory adverse events (PRAEs) and neuromuscular recovery following reversal of vecuronium-induced neuromuscular blockade with sugammadex versus neostigmine in patients undergoing functional endoscopic sinus surgery (FESS).

Methods

In this prospective randomized double-blind study, 70 ASA I–II patients undergoing FESS were allocated to receive either sugammadex 4 mg/kg (Group A) or neostigmine 0.05 mg/kg with glycopyrrolate 0.4 mg (Group B). Neuromuscular function was monitored using train-of-four (TOF). The primary outcome was incidence of PRAEs. Secondary outcomes included time to TOF recovery, haemodynamics, and recovery profile.

Results

PRAEs were significantly lower in Group A (17.1%) compared with Group B (74.3%) (p < 0.001). Bucking and straining were significantly higher in Group B (p < 0.001). Time to TOF recovery was significantly shorter with sugammadex (122.14 ± 56.82 s vs 465.71 ± 113.05 s; p < 0.001). Haemodynamic variables were comparable between groups.

Conclusion

Sugammadex provides faster neuromuscular recovery and significantly reduces early PRAEs compared with neostigmine in Functional endoscopic sinus surgery patients.