Analgesic and Anesthetic Efficacy of Rocuronium/Sugammadex in Otorhinolaryngologic Surgery: A Propensity Score-Matched Analysis

Wu, En-Bo; Hung, Chao-Ting; Luo, Sheng‐Dean; Wu, Shao-Chun; Lee, Tsung-Yang; Chin, Jo-Chi; Tsai, Peng-Neng; Yang, Johnson Chia‐Shen

doi:10.3390/ph15070894

Cited by 3 publications

(2 citation statements)

References 55 publications

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“…Fourth, we did not compare the intraoperative consumption of volatile anesthetics between the two groups due to data unavailability. Wu et al recently showed that the use of rocuronium/sugammadex was associated with lower dosages of volatile anesthetics and opioids compared with cisatracurium/neostigmine [35]. Fifth, a small number of patients (4.1%) in the neostigmine group used cisatracurium in the original cohort.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Cost-Effectiveness of Sugammadex Versus Neostigmine to Reverse Neuromuscular Blockade in a University Hospital in Taiwan: A Propensity Score-Matched Analysis

et al. 2023

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Sugammadex has several pharmacological advantages over neostigmine, including faster reversal of neuromuscular blockade and fewer adverse effects. However, the economic impact of sugammadex remains controversial due to the considerable heterogeneity of study designs and clinical settings in previous studies. In a post-hoc analysis of a randomized controlled trial, we evaluated patients who underwent elective surgeries and general anesthesia with endotracheal intubation in a medical center in Taiwan between March 2020 and August 2020. Patients were divided into either the sugammadex or neostigmine group based on the neuromuscular blocking drug used. Propensity score matching was used to balance the baseline patient characteristics between the two groups. The patient’s recovery from anesthesia and the putative cost-effectiveness of sugammadex versus neostigmine was assessed. Derived cost-effectiveness using personnel costs in the operating room and the post-anesthesia care unit was estimated using multiple linear regression models. A total of 2587 and 1784 patients were included before and after matching, respectively. Time to endotracheal extubation was significantly shorter in the sugammadex group (mean 6.0 ± standard deviation 5.3 min) compared with the neostigmine group (6.6 ± 6.3 min; p = 0.0032). In addition, the incidence of bradycardia was significantly lower in the sugammadex group (10.2%) compared with the neostigmine group (16.9%; p < 0.001). However, the total costs were significantly lower in the neostigmine group (50.6 ± 21.4 United States dollars) compared with the sugammadex group (212.0 ± 49.5 United States dollars). Despite improving postoperative recovery, the benefits of sugammadex did not outweigh its higher costs compared with neostigmine, possibly due to the low costs of labor in Taiwan’s healthcare system.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Cost-Effectiveness of Sugammadex Versus Neostigmine to Reverse Neuromuscular Blockade in a University Hospital in Taiwan: A Propensity Score-Matched Analysis

et al. 2023

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“…This study aims to evaluate the frequency with which fistulectomy patients require a change from local to general or spinal anesthesia [14].…”

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confidence: 99%

Surgery for Simple Anal Fistula under Local Anesthesia

Iqbal¹,

Jamil²,

Saleem³

et al. 2022

PJMHS

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Background: Infections of the anal glands, which drain into the anal crypts, account for more than 95% of all cases of anorectal abscess. Although fistula-in-ano is usually harmless, it can nonetheless cause severe pain and significantly impact patients' day-to-day lives. Even though most anorectal procedures are performed when the patient is under general or regional anesthesia, there is mounting proof that these procedures can be done safely and effectively in an outpatient setting using only local anesthesia. All procedures in the current investigation were performed with local anesthesia, specifically, 2% lidocaine and 0.5 % bupivacaine. Place and Duration of study: Departments of General Surgery, HMC Peshawar and Nishtar Hospital, Multan for the duration of six months from June 2021 to November 2021. Method: Including the time needed to inject the anesthetic, the typical surgical procedure lasted around 26 minutes. No patient reported more than a 7 on a visual analogue scale for pain on the day of surgery, or the first postoperative day. In most cases, patients spend around two days in the hospital. Results: Including the time needed to inject the anesthetic, the typical surgical procedure lasted around 26 minutes. No patient reported more than a 7 on a visual analogue scale for pain on the day of surgery, the day of surgery, or the first postoperative day. In most cases, patients spend around two days in the hospital. Conclusion: With early ambulation, good tolerability, and fewer anaesthetic problems, local fistula in- ano repair anesthesia is a safe and effective option. In-Ano Fistula, VAS, and Local Anesthetics are some of the terms that will be discussed.

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Comparison of sevoflurane and propofol in combination with remifentanil on the quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery

Shu,

Lin,

et al. 2024

Front. Med.

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ObjectiveThis study aimed to evaluate and compare the effects of sevoflurane + remifentanil (Sev + Rem) and propofol + remifentanil (Pro + Rem) on the postoperative recovery quality of patients undergoing laparoscopic bariatric surgery to determine which anesthesia regimen provides a better overall recovery experience.MethodsSixty patients were divided into two groups based on the treatments they underwent: Sev + Rem (n = 30) and Pro + Rem (n = 30). The Sev + Rem group received sevoflurane inhalation (0.5%, increasing to 0.5–4%) and remifentanil via target-controlled infusion. The Pro + Rem group received propofol [4–8 mg/(kg·h)] and remifentanil via target-controlled infusion. Anesthesia depth was maintained at a bispectral index of 40–60 in both groups. Perioperative data, hemodynamic parameters, and postoperative recovery quality were assessed.ResultsCompared to the Pro + Rem group, the dose of remifentanil in the Sev + Rem group was significantly lower (1693.67 ± 331.75 vs. 2,959 ± 359.77, p < 0.001), the proportion of patients used norepinephrine was markedly higher [16 (53.33) vs. 8 (26.67), p = 0.035], and the time of extubation was earlier (356.33 ± 63.17 vs. 400.3 ± 50.11, p = 0.004). The Hemodynamic results showed the HR in the Sev + Rem group was faster than that in the Pro + Rem group at the beginning of surgery and 1 h post-surgery (67.37 ± 4.40 vs. 64.33 ± 4.44, p = 0.010, 69.07 ± 4.23 vs. 66.40 ± 5.03, p = 0.030). In regard to the assessment of postoperative recovery quality, the emotional state scores in the Sev + Rem group were significantly lower than the Pro + Rem group (36.83 ± 2.79 vs. 39.50 ± 4.64, p = 0.009).ConclusionThe two anesthesia modalities (Sev + Rem and Pro + Rem) have their advantages and disadvantages for patients undergoing laparoscopic bariatric surgery and have comparable effects on postoperative recovery quality.

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Analgesic and Anesthetic Efficacy of Rocuronium/Sugammadex in Otorhinolaryngologic Surgery: A Propensity Score-Matched Analysis

Cited by 3 publications

References 55 publications

Cost-Effectiveness of Sugammadex Versus Neostigmine to Reverse Neuromuscular Blockade in a University Hospital in Taiwan: A Propensity Score-Matched Analysis

Cost-Effectiveness of Sugammadex Versus Neostigmine to Reverse Neuromuscular Blockade in a University Hospital in Taiwan: A Propensity Score-Matched Analysis

Surgery for Simple Anal Fistula under Local Anesthesia

Comparison of sevoflurane and propofol in combination with remifentanil on the quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery

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