Sugammadex use can decrease the incidence of post-operative urinary retention by avoiding anticholinergics: a retrospective study

Cha, Jeongho; Park, Sung Wook; Choi, Young In; Oh, In Duk; Kang, Hyungsook; Lee, Sang Hyub; Choi, Jeong-Hyun

doi:10.17085/apm.2018.13.1.40

Cited by 13 publications

(15 citation statements)

References 19 publications

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“…A number of previous studies have confirmed that the use of sugammadex for the reversal of NMB agents can lead to fewer incidents of respiratory complications, residual neuromuscular block, and PONV compared with the use of AChEIs [5,6]. The relevant literature also lists the advantages of the drug in terms of recovery of the cardiovascular system, urinary system, and other systems [23,24].…”

Section: Discussionmentioning

confidence: 99%

Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility

Noh

Kim

Lee

et al. 2020

Korean J Anesthesiol

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Background: Acetylcholinesterase inhibitors (e.g., pyridostigmine bromide) are used for neuromuscular blockade (NMB) reversal in patients undergoing surgery under general anesthesia (GA). Concurrent use of anticholinergic agents (e.g., glycopyrrolate) decreases cholinergic side effects but can impede bowel movements. Sugammadex has no cholinergic effects; its use modifies recovery of gastrointestinal (GI) motility following laparoscopic cholecystectomy compared to pyridostigmine/glycopyrrolate. This study evaluated the contribution of sugammadex to the recovery of GI motility compared with pyridostigmine and glycopyrrolate. Methods: We conducted a prospective study of patients who underwent laparoscopic cholecystectomy. Patients were randomly allocated to the experimental group (sugammadex, Group S) or control group (pyridostigmine-glycopyrrolate, Group P). After anesthesia (propofol and rocuronium, and 2% sevoflurane), recovery was induced by injection of sugammadex or a pyridostigmine-glycopyrrolate mixture. As a primary outcome, patients recorded the time of their first passage of flatus ('gas-out time') and defecation. The secondary outcome was stool types. Results: One-hundred and two patients participated (Group S [n = 49], Group P [n = 53]). Mean time from injection of NMB reversal agents to gas-out time was 15.03 (6.36-20.25) h in Group S and 20.85 (16.34-25.86) h in Group P (P = 0.001). Inter-group differences were significant. Time until the first defecation as well as types of stools was not significantly different. Conclusions: Sugammadex after laparoscopic cholecystectomy under GA resulted in an earlier first postoperative passage of flatus compared with the use of a mixture of pyridostigmine and glycopyrrolate. These findings suggest that the use of sugammadex has positive effects on the recovery of GI motility.

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Section: Discussionmentioning

confidence: 99%

Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility

Noh

Kim

Lee

et al. 2020

Korean J Anesthesiol

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“…A number of previous studies have confirmed that the use of sugammadex for the reversal of NMB agents can lead to fewer incidents of respiratory complications, residual MNB, and PONV compared with the use of AChEIs [5,6]. The relevant literature also lists the advantages of the drug in terms of recovery of the cardiovascular system, urinary system, and other systems [23,24].…”

Section: Discussionmentioning

confidence: 99%

Smartphones are definitely a boon in operation theatre if used smartly enough

Gupta

2019

Korean J Anesthesiol

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“…Glycopyrrolate, an anticholinergic agent, is commonly used in conjunction with neostigmine, an anticholinesterase, for the reversal of neuromuscular blockade created by NDNMB. Bladder detrusor contraction and internal urethral sphincter relaxation during micturition are controlled by parasympathetic stimulation via muscarinic receptors; therefore, blockade of these post-junctional excitatory muscarinic receptors in the detrusor muscle causes bladder hypotonia and increases the frequency of urinary retention [ 8 ]. Besides reversing neuromuscular blockade, glycopyrrolate is also used to decrease oral, tracheobronchial, and pharyngeal secretions, and to treat bradycardia [ 9 ].…”

Section: Reviewmentioning

confidence: 99%

“…Specifically, Sugammadex, a selective relaxant binding agent, is a viable alternative that has recently been introduced into clinical practice [ 5 ]. Sugammadex is used to reverse muscle relaxation through strong, rapid, one-to-one, encapsulation with NDNMB in the plasma [ 6 , 8 ]. It has no effect on acetylcholinesterase and prevents blockade of the neuromuscular junction without the undesired muscarinic side effects [ 22 , 23 ].…”

Section: Reviewmentioning

confidence: 99%

“…Cha et al compared the incidence of urinary retention between patients who received Sugammadex and those who received anticholinesterases with anticholinergics for reversal of neuromuscular blockade in a retrospective cohort. They found that the incidence of urinary retention was significantly lower in the Sugammadex group compared to the glycopyrrolate group (36.1 vs. 48.8%, P = 0.003) [ 8 ]. They concluded that the use of Sugammadex was associated with a lower incidence of urinary retention by avoiding glycopyrrolate.…”

Section: Reviewmentioning

confidence: 99%

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Glycopyrrolate and Post-Operative Urinary Retention: A Narrative Review

Low

Escobar

Baquero

et al. 2020

Cureus

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The use of non-depolarizing neuromuscular blockade (NDNMB) necessitates the use of reversal agents. Glycopyrrolate, an anticholinergic agent, is commonly used in combination with neostigmine, an anticholinesterase, for the reversal of neuromuscular blockade medications. Glycopyrrolate is known to effect on the genitourinary system adversely with an inhibitory effect on bladder contraction, bladder hypotonia, and increase in the frequency of urinary retention. Many studies analyzing the association between glycopyrrolate and urinary retention are outdated and published over a decade ago. The decade old studies were retrospective and did not consider post-operative urinary retention (POUR) as a primary outcome. The purpose of this manuscript is to review the association between glycopyrrolate administration and post-operative urinary retention in the perioperative setting.

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Sugammadex use can decrease the incidence of post-operative urinary retention by avoiding anticholinergics: a retrospective study

Cited by 13 publications

References 19 publications

Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility

Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility

Smartphones are definitely a boon in operation theatre if used smartly enough

Glycopyrrolate and Post-Operative Urinary Retention: A Narrative Review

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