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. 2020 Oct 22;7(6):572-578.
doi: 10.14744/nci.2020.21298. eCollection 2020.

Retrospective evaluation of the effects of sugammadex and neostigmine on the IgE and eosinophil cationic protein in morbid obese patients

Ozkan Gorgulu  1 , Mehmet Nuri Kosar  2
Affiliations

Retrospective evaluation of the effects of sugammadex and neostigmine on the IgE and eosinophil cationic protein in morbid obese patients

Ozkan Gorgulu et al. North Clin Istanb. .

Abstract

Objective: This study was designed to show that allergic reactions with gamma cyclodextrin-related caused by sugammadex are not anaphylaxis but an anaphylactoid reaction.

Methods: In this retrospective study, 83 morbidly obese patients, who underwent elective laparoscopic sleeve gastrectomy operation, were included. Patient data were obtained from patient files and electronic health records system (SARUS). The patients were divided into two groups as sugammadex (Group S) and neostigmine (Group N). Patient data were recorded, including patient preoperative demographics (age, gender) and preoperative and postoperative (12 hours later) levels of total IgE and ECP (Eosinophil cationic protein) levels.

Results: There was not a significant change in the total IgE levels in Group S or Group N (p>0.05); however, the levels of ECP significantly decreased in both groups (p<0.001, p=0.01). In the patients in Group S, the preoperative levels of total IgE were significantly positively, and weakly correlated with the preoperative ECP (p=0.311, p=0.045) and postoperative ECP (p=0.310, p=0.046) levels.

Conclusion: Allergic reactions that arise from sugammadex related with gamma-cyclodextrin are non-IgE mediated anaphylactoid reactions. Anaphylactoid reaction was not observed after administration of 2 mg kg-1 sugammadex intravenously in patients with morbid obesity.

Keywords: Sugammadex; anaphylaxis; cyclodextrins; eosinophil cationic protein; immunoglobulin e; neostigmine.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

FIGURE 1
FIGURE 1
Normal adult spirometry.
FIGURE 2
FIGURE 2
Distal airway obstruction.
FIGURE 3
FIGURE 3
Pathophysiology of anaphylaxis and anaphylactoid reactions.
See this image and copyright information in PMC

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