Reversal of neuromuscular blockade with sugammadex or neostigmine/atropine: Effect on postoperative gastrointestinal motility

Abstract

Study objective: To compare sugammadex with conventional reversal of neuromuscular block in terms of postoperative gastrointestinal motility.

Design: Double blinded, randomized, controlled clinical trial.

Setting: Operating room, postoperative recovery area.

Patients: Seventy-two patients with ASA physical status I or II, scheduled for total thyroid surgery were studied.

Interventions: When 4 twitches were observed on train-of-four stimulation, neuromuscular block was reversed conversatively in the control group, and with sugammadex in the study group.

Measurements: Time to first flatus and feces, incidence of postoperative nausea, vomiting, diarrhea and constipation were collected.

Main results: Median time of first flatus was 24 hours (18-32 [10-36]) in the neostigmine group, and 24 (18-28 [12-48]) in the sugammadex group (P > .05). Median (IQR) time of first feces was 24 hours (18-36 [10-48]) in neostigmine group, 32 hours (28-36 [12-72]) in sugammadex group (P > .05). There were no occurrences of nausea, vomiting, diarrhea, or constipation.

Conclusions: Sugammadex may be safely used in cases where postoperative ileus is expected.

Keywords: Constipation; Neostigmine; Neuromuscular agents; Postoperative period; Sugammadex.