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@article{1343447,
author = {Štourač, Petr and Adamus, Milan and Seidlová, Dagmar and Pavlík, Tomáš and Janků, Petr and Křikava, Ivo and Mrozek, Zdenek and Procházka, Martin and Klučka, Jozef and Štoudek, Roman and Bártíková, Ivana and Kosinová, Martina and Harazim, Hana and Robotková, Hana and Hejduk, Karel and Hodická, Zuzana and Kirchnerova, Martina and Frančáková, Jana and Obare Pyszkova, Lenka and Hlozkova, Jarmila and Ševčík, Pavel},
article_location = {Philadelphia},
article_number = {5},
doi = {http://dx.doi.org/10.1213/ANE.0000000000001197},
keywords = {cesarean delivery; active reversla of neuromuscular blockade; intubation conditions; postoperative complications},
language = {eng},
issn = {0003-2999},
journal = {Anesthesia and Analgesia},
title = {Low-dose or high-dose rocuronium reversed with neostigmine or sugammadex for cesarean delivery anesthesia: A randomized controlled non-inferiority trial of time to tracheal intubation and extubation.},
volume = {122},
year = {2016}
}
TY - JOUR
ID - 1343447
AU - Štourač, Petr - Adamus, Milan - Seidlová, Dagmar - Pavlík, Tomáš - Janků, Petr - Křikava, Ivo - Mrozek, Zdenek - Procházka, Martin - Klučka, Jozef - Štoudek, Roman - Bártíková, Ivana - Kosinová, Martina - Harazim, Hana - Robotková, Hana - Hejduk, Karel - Hodická, Zuzana - Kirchnerova, Martina - Frančáková, Jana - Obare Pyszkova, Lenka - Hlozkova, Jarmila - Ševčík, Pavel
PY - 2016
TI - Low-dose or high-dose rocuronium reversed with neostigmine or sugammadex for cesarean delivery anesthesia: A randomized controlled non-inferiority trial of time to tracheal intubation and extubation.
JF - Anesthesia and Analgesia
VL - 122
IS - 5
SP - 1536-1545
EP - 1536-1545
PB - Lippincott Williams & Wilkins
SN - 00032999
KW - cesarean delivery
KW - active reversla of neuromuscular blockade
KW - intubation conditions
KW - postoperative complications
N2 - BACKGROUND: Rocuronium for cesarean delivery under general anesthesia is an alternative to succinylcholine for rapid-sequence induction of anesthesia because of the availability of sugammadex for reversal of neuromuscular blockade. However, there are no large well-controlled studies in women undergoing general anesthesia for cesarean delivery. The aim of this noninferiority trial was to determine whether rocuronium and sugammadex confer benefit in time to tracheal intubation (primary outcome) and other neuromuscular blockade outcomes compared with succinylcholine, rocuronium, and neostigmine in women undergoing general anesthesia for cesarean delivery. RESULTS: We enrolled 240 parturients. The mean time to tracheal intubation was 2.9 seconds longer in the ROC group (95% confidence interval, -5.3 to 11.2 seconds), noninferior compared with the SUX group. Absence of laryngoscopy resistance was greater in the ROC than in the SUX groups (ROC, 87.5%; SUX, 74.2%; P = 0.019), but there were no differences in vocal cord position (P = 0.45) or intubation response (P = 0.31) between groups. No statistically significant differences in incidence of anesthesia complications or in neonatal outcome were found (10 minute Apgar score, P = 0.07; umbilical artery pH, P = 0.43). The incidence of postpartum myalgia was greater in the SUX group (ROC 0%; SUX 6.7%; P = 0.007). The incidence of subjective complaints was lower in the ROC group (ROC, 21.4%; SUX, 37.5%; P = 0.007). CONCLUSIONS: We conclude that rocuronium for rapid-sequence induction is noninferior for time to tracheal intubation and is accompanied by more frequent absence of laryngoscopy resistance and lower incidence of myalgia in comparison with succinylcholine for cesarean delivery under general anesthesia.
ER -
ŠTOURAČ, Petr, Milan ADAMUS, Dagmar SEIDLOVÁ, Tomáš PAVLÍK, Petr JANKŮ, Ivo KŘIKAVA, Zdenek MROZEK, Martin PROCHÁZKA, Jozef KLUČKA, Roman ŠTOUDEK, Ivana BÁRTÍKOVÁ, Martina KOSINOVÁ, Hana HARAZIM, Hana ROBOTKOVÁ, Karel HEJDUK, Zuzana HODICKÁ, Martina KIRCHNEROVA, Jana FRANČÁKOVÁ, Lenka OBARE PYSZKOVA, Jarmila HLOZKOVA and Pavel ŠEVČÍK. Low-dose or high-dose rocuronium reversed with neostigmine or sugammadex for cesarean delivery anesthesia: A randomized controlled non-inferiority trial of time to tracheal intubation and extubation. \textit{Anesthesia and Analgesia}. Philadelphia: Lippincott Williams \&{} Wilkins, 2016, vol.~122, No~5, p.~1536-1545. ISSN~0003-2999. Available from: https://dx.doi.org/10.1213/ANE.0000000000001197.
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