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Revista Cubana de Anestesiología y Reanimación

versão On-line ISSN 1726-6718

Resumo

CORDERO ESCOBAR, Idoris; REY MARTINEZ, Beatriz; COMPANY TEULER, Roque  e  PEREZ CARBONELL, Ana. Reversion of rocuronium with sugammadex in patients underwent lengthy procedures. Rev cuba anestesiol reanim [online]. 2011, vol.10, n.2, pp. 152-157. ISSN 1726-6718.

Rocuronium is included in the non-depolarization muscular relaxants with less accumulation. However, high doses may to increase its accumulation. Objectives: To present the course of patients with relatively lengthy surgical-anesthetic times relaxed using bolus rocuronium and reverted with sugammadex. Cases presentations: A.P.S., aged 35, male sex, weighing 70 Kgs. ASA III risk classification, allergy to penicillin; Mallampatti II; Chron’s disease for left hemicholectomy and J.F. G. aged 51, male sex, weighing 90 Kg. ASA II risk classification; T of sigmoid for sigmoidectomy. In both patients, we carried out induction using propofol 2 mg/kg, phentanyl 5 µg/kg (70 mg) Intubation was easy. Volumetric ventilation was used and monitoring of oximmetry, capnography, heart rate, invasive blood pressure and electrocardiogram, bi-spectral rate and neuromuscular function. Maintenance: the infusion pump at a rate of 5 mg/kg/h of propofol and phentanyl at a rate of 2.5 µg/kg bolus. 20 mg rocuronium were administered in the first case and 30 mg in the second one in two occasions. Surgery length was of 2 hours and 30 minutes and 2 hours and 45 minutes, respectively. At the end of intervention it was possible to achieve two responses in the chain of four with clinical signs of residual relaxation. Sugammadex (2 mg/kg)was administered and in the first patient recovery time was at 2 minutes and 15 seconds and in the second one it was of 2 hours and 10 seconds with a T4/T1 of 89 and 91%, respectively. Extubation was without complications. Conclusions: The sugammadex is a reversion of novel mechanism of action that could offer some advantages on those used until now.

Palavras-chave : Sugammadex; reversión del bloqueo; acumulación; Sugammadex; blockage reversion; accumulation.

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