title: Comparison of neostigmine and sugammadex for hemodynamic parameters in cardiac patients undergoing noncardiac surgery.
abstract: OBJECTIVE
  The aim of this study is to compare the hemodynamic effects of neostigmine-atropine combination and sugammadex in patients with cardiac problems undergoing noncardiac surgery.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  In the operating room.
  
  
  METHODS
  Ninety patients with a class 2 or 3 cardiovascular disease according to the New York Heart Association classification and aged between 18 and 75 years undergoing noncardiac surgery were randomized.
  
  
  METHODS
  Group N (n = 45) received 0.03 mg/kg IV neostigmine when T2 appeared as measured with a nerve muscle stimulator. When heart rate was 5 beats/min (±10 beats/min) lower than the heart rate before administration of the medication, 0.5 mg IV atropine sulfate was given. Group S (n = 45) received 3 mg/kg IV sugammadex when T2 appeared as measured with a nerve muscle stimulator.
  
  
  METHODS
  Heart rate, mean systolic and diastolic blood pressures, and electrocardiographic alterations including the QTc (QT Fredericia and QT Bazett) were recorded.
  
  
  RESULTS
  There were no significant differences between and within the groups in terms of QTc values. Sugammadex group had a significant decrease on heart rate 1 minute after the medication when compared to the measurement before the medication (P < .05). Heart rate and systolic blood pressure increased in neostigmine group 3 minutes after the medication and during postoperative measurements (P < .05). Sugammadex group had lower systolic, diastolic, and mean blood pressures and heart rate when compared to neostigmine group (P < .05).
  
  
  CONCLUSIONS
  We suggest that sugammadex might be preferred as it provides more hemodynamic stability compared to neostigmine-atropine combination to reverse rocuronium-induced neuromuscular blockage in cardiac patients undergoing noncardiac surgery.
authors.affiliation: Department of Anesthesiology, Marmara University Medical School, Istanbul, Turkey. Electronic address: denizkizilay@yahoo.com.
authors.forename: Deniz
authors.initials: D
authors.lastname: Kizilay
authors.affiliation: Department of Anesthesiology, Marmara University Medical School, Istanbul, Turkey.
authors.forename: Didem
authors.initials: D
authors.lastname: Dal
authors.affiliation: Department of Anesthesiology, Marmara University Medical School, Istanbul, Turkey.
authors.forename: Kemal T
authors.initials: KT
authors.lastname: Saracoglu
authors.affiliation: Department of Anesthesiology, Marmara University Medical School, Istanbul, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Eti
authors.affiliation: Department of Anesthesiology, Marmara University Medical School, Istanbul, Turkey.
authors.forename: Fevzi Y
authors.initials: FY
authors.lastname: Gogus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D004558:Electric Stimulation; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000627:therapeutic use*; D010277:Parasympathomimetics / Q000627:therapeutic use*; D011446:Prospective Studies; D000077122:Sugammadex; D013514:Surgical Procedures, Operative / Q000379:methods*; D055815:Young Adult; D047408:gamma-Cyclodextrins / Q000627:therapeutic use*
chemical_list: D010277:Parasympathomimetics; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine
keywords: Atropine; Cardiac patient; Gamma-cyclodextrin; Neostigmine; Rocuronium; Sugammadex