title: A comparison of sugammadex and neostigmine for reversal of rocuronium-induced neuromuscular blockade in children.
abstract: BACKGROUND
  Sugammadex is designed to be a reversal agent for steroidal muscle relaxants. The current trial was aimed to compare between sugammadex and neostigmine concerning the recovery time from neuromuscular blockade. We hypothesised that sugammadex might have shorter recovery time than neostigmine.
  
  
  METHODS
  Sixty paediatric patients aged 2-10 years scheduled for lower abdominal surgeries were randomly assigned into two equal groups to receive 4 mg/kg sugammadex (Group S) or 0.35 mg/kg neostigmine and 0.02 mg/kg atropine (Group N) as a reversal agent for rocuronium at the end of surgery. Primary outcome was the recovery time [time from starting of sugammadex or neostigmine till reaching train of four (TOF) ratio> 0.9] whereas secondary outcomes included number of patients who needed another dose of sugammadex or neostigmine to reach TOF ratio> 0.9, extubation time (time from stoppage of anaesthetic inhalation until the patient fulfilled criteria for safe extubation, post-anaesthesia care unit (PACU) discharge time and post-operative adverse effects.
  
  
  RESULTS
  The mean recovery and extubation times were significantly shorter (P = 0.002 and 0.005) in Group S compared with Group N (2.5 and 2.0 min vs. 12.6 min and 4.3 min respectively). In the Group N, eight patients needed another reversal dose compared with one patient in Group S (P = 0.035). PACU discharge time showed no significant difference between both groups. Incidence of nausea, vomiting, tachycardia, and dry mouth were significantly higher in Group N.
  
  
  CONCLUSIONS
  Sugammadex administration in children resulted in faster recovery and extubation times and lower incidence of adverse events compared with neostigmine.
authors.affiliation: Faculty of Medicine, Minoufiya University, Minoufiya, Egypt.
authors.forename: A S
authors.initials: AS
authors.lastname: Ammar
authors.affiliation: Faculty of Medicine, Minoufiya University, Minoufiya, Egypt.
authors.forename: K M
authors.initials: KM
authors.lastname: Mahmoud
authors.affiliation: Faculty of Medicine, Minoufiya University, Minoufiya, Egypt.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Kasemy
mesh_terms: D000005:Abdomen / Q000601:surgery; D000732:Androstanols / Q000009:adverse effects / Q000037:antagonists & inhibitors*; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D001285:Atropine; D002648:Child; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D018727:Muscarinic Antagonists; D009388:Neostigmine / Q000009:adverse effects; D019148:Neuromuscular Blockade / Q000009:adverse effects / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects / Q000037:antagonists & inhibitors*; D011183:Postoperative Complications / Q000139:chemically induced / Q000453:epidemiology; D000077123:Rocuronium; D000077122:Sugammadex; D016896:Treatment Outcome; D047408:gamma-Cyclodextrins / Q000009:adverse effects
chemical_list: D000732:Androstanols; D002800:Cholinesterase Inhibitors; D018727:Muscarinic Antagonists; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D009388:Neostigmine; D001285:Atropine; D000077123:Rocuronium