title: Comparison of sugammadex and conventional reversal on postoperative nausea and vomiting: a randomized, blinded trial.
abstract: OBJECTIVE
  To determine whether the new selective binding agent sugammadex causes less postoperative nausea and vomiting (PONV) than the cholinesterase inhibitor neostigmine.
  
  
  METHODS
  Prospective, randomized, double-blinded study.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  One hundred American Society of Anesthesiologists physical status 1 and 2 patients scheduled for extremity surgery.
  
  
  METHODS
  Patients were randomly assigned to neostigmine (70 μg/kg) and atropine (0.4 mg per mg neostigmine) or sugammadex 2 mg/kg for neuromuscular antagonism at the end of anesthesia, when 4 twitches in response to train-of-four stimulation were visible with fade.
  
  
  METHODS
  We recorded PONV, recovery parameters, antiemetic consumption, and side effects.
  
  
  RESULTS
  Nausea and vomiting scores were lower in the sugammadex patients upon arrival in the postanesthesia care unit (med: 0 [min-max, 0-3] vs med: 0 [min-max, 0-3]; P < .05), but thereafter low and comparable. Postoperative antiemetic and analgesic consumption were similar in each group. Extubation (median [interquartile range], 3 [1-3.25] vs 4 [1-3.25]; P < .001) first eye opening (4 [3-7.25] vs 7 [5-11]; P < .001), and head lift (4 [2-7.25] vs 8 [11-25]; P < .001) in minutes were shorter in patients given sugammadex. Postoperative heart rates were significantly lower in all measured times patients given neostigmine.
  
  
  CONCLUSIONS
  Nondepolarizing neuromuscular blocking antagonism with sugammadex speeds recovery of neuromuscular strength but only slightly and transiently reduces PONV compared with neostigmine and atropine.
authors.affiliation: Department of Anaesthesiology, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey; Department of Outcomes Research, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey. Electronic address: onurko@yahoo.com.
authors.forename: Onur
authors.initials: O
authors.lastname: Koyuncu
authors.affiliation: Department of Anaesthesiology, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey.
authors.forename: Selim
authors.initials: S
authors.lastname: Turhanoglu
authors.affiliation: Department of Anaesthesiology, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey.
authors.forename: Cagla
authors.initials: C
authors.lastname: Ozbakis Akkurt
authors.affiliation: Department of Anaesthesiology, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Karcıoglu
authors.affiliation: Department of Plastic Surgery, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ozkan
authors.affiliation: Department of Family Medicine, Mustafa Kemal University Tayfur Ata Sokmen Medicine Faculty, Hatay, Turkey.
authors.forename: Cahit
authors.initials: C
authors.lastname: Ozer
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Sessler
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Turan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001285:Atropine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000008:administration & dosage* / Q000009:adverse effects; D010865:Pilot Projects; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced / Q000453:epidemiology*; D011446:Prospective Studies; D000077122:Sugammadex; D055815:Young Adult; D047408:gamma-Cyclodextrins / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine; D001285:Atropine
keywords: Neostigmine; Postoperative nausea; Sugammadex; Vomiting