The effect of sugammadex on steroid hormones: A randomized clinical study.
OBJECTIVE
Sugammadex is an alternative drug to traditional decurarization by cholinesterase inhibitors. It has been examined the effect of sugammadex on steroid hormones in this study.


METHODS
Randomized clinical trial.


METHODS
The study was conducted in a University Teaching Hospital from January 2013 to May 2014.


METHODS
Fifty male patients between 18 and 45years of age with an American Society of Anesthesiology (ASA) class I or II undergoing elective lower extremity surgery were included in this study.


METHODS
Patients were categorized into two groups (neostigmin group, Group N; and sugammadex group, Group S). In addition to standard monitorization, train-of-four (TOF) was also used to monitorize the level of neuromuscular blockade. Standard induction and maintenance of anesthesia were performed. At the termination of surgery, neuromuscular blockade was antagonized using 0.05mg/kg of neostigmine and 0.01mg/kg of atropin when spontaneous recovery of neuromuscular blockade occurred with the reappearance of T2 in Group N and using 4mg/kg sugammadex in Group S.


METHODS
The primary outcome in this study was to determine serum aldosterone, cortisol, progesterone, and free testosterone levels. Three blood samples were obtained in each patient just before and 15minutes and 4hours after antagonism,


RESULTS
No significant differences were found in demographic characteristics between the groups. While there were no differences in serum progesterone levels, patients in neostigmin group had significantly higher cortisol levels at 15minutes as compared to baseline. Also, patients in sugammadex group had significantly higher serum aldosterone and testosterone levels 15minutes after antagonism as compared to those in the neostigmine group.


CONCLUSIONS
Our findings suggest that sugammadex is not associated with adverse effects on steroid hormones progesterone and cortisol, while it may lead to a temporary increase in aldosterone and testosterone.
Department of Anesthesiology and Reanimation, Firat University.
Gulay
G
Gunduz Gul
Department of Anesthesiology and Reanimation, Firat University. Electronic address: abelinozer@gmail.com.
Ayse B
AB
Ozer
Department of Anesthesiology and Reanimation, Firat University.
Ismail
I
Demirel
Department of Anesthesiology and Reanimation, Firat University.
Ahmet
A
Aksu
Department of Anesthesiology and Reanimation, Firat University.
Omer L
OL
Erhan
D000328:Adult; D000450:Aldosterone / Q000097:blood; D000732:Androstanols / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D000762:Anesthesia Recovery Period; D001285:Atropine / Q000008:administration & dosage; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D009388:Neostigmine / Q000008:administration & dosage / Q000009:adverse effects*; D019148:Neuromuscular Blockade / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D011374:Progesterone / Q000097:blood; D000077123:Rocuronium; D013256:Steroids / Q000097:blood*; D000077122:Sugammadex; D013739:Testosterone / Q000097:blood; D055815:Young Adult; D047408:gamma-Cyclodextrins / Q000008:administration & dosage / Q000009:adverse effects*
D000732:Androstanols; D002800:Cholinesterase Inhibitors; D003473:Neuromuscular Nondepolarizing Agents; D013256:Steroids; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine; D013739:Testosterone; D000450:Aldosterone; D011374:Progesterone; D001285:Atropine; D006854:Hydrocortisone; D000077123:Rocuronium
Sugammadex; aldosterone; cortisol; insulin; progesterone