Key result
Sugammadex significantly shortened the median operation room discharge time to 18.6 minutes compared to 20.3 minutes in the control group following desflurane anesthesia lasting over 2 hours.
Why the study?
Inhalational anesthetics enhance and prolong the duration of non-depolarizing neuromuscular blocking drugs, prompting investigation into the effectiveness of sugammadex following general anesthesia exceeding 2 hours.
Does sugammadex reduce operation room stay in adult patients undergoing oral maxillofacial surgery under prolonged desflurane anesthesia?
Cohort (n=225)
No
Does sugammadex reduce operation room stay in adult patients undergoing oral maxillofacial surgery under prolonged desflurane anesthesia?
Absolute Event Rate: 18.6% vs 20.3%
p-value: p=0.0087
Sugammadex significantly shortens operating room discharge time following prolonged desflurane anesthesia in oral maxillofacial surgery.
May aid OR efficiency after prolonged desflurane; leaves open confirmation in randomized trials before practice change.
Background Neuromuscular monitoring may not be monitored in oral surgery, because muscle relaxant effect is not required except for intubation maneuvers. In clinical anesthesia, we have extubated after recovery of enough spontaneous breathing, swallowing, and airway protection reflexes. The use of sugammadex depends on the preference of the anesthesiologist. Inhalational anesthetics enhances the effects of non-depolarizing neuromuscular blocking drugs and prolongs its duration of action and recovery. Then, we should pay attention to the prolonged muscle relaxant actin after prolonged anesthesia time. Then, we retrospectively investigated the effectiveness of sugammadex following general anesthesia (>2 hours). Methods We examined the anesthesia records of adult patients who underwent oral surgery under general anesthesia (>2 hours) using rocuronium for tracheal intubation and desflurane for maintenance. The following parameters were recorded: patient background, extubation time (i.e., time between desflurane cessation and extubation), and discharge time (i.e., time between desflurane cessation and operation room departure). Results Two hundreds twenty-five patients were divided into two groups (sugammadex group, n = 133, control group, n = 92). Patients in the sugammadex group received sugammadex (2–4 mg/kg) once desflurane was stopped. There were no significant differences in patient backgrounds between the groups. Although it did not reach the level of significance (p = 0.32), the extubation time in the sugammadex group (10 minutes) was shorter than that of the control group (10 minutes). The discharge time in the sugammadex group (18 minutes) was significantly shorter than that of the control group (20 minutes; p = 0.0087). Conclusion The use of sugammadex could shorten operation room stay after desflurane anesthesia (>2 hours) in adult patients undergoing oral maxillofacial surgery. We found that it was possible to make quick muscle recovery with the use of sugammadex, then the patients could return to the hospital ward.
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Hano et al. (2022) conducted a cohort in Oral maxillofacial surgery under general anesthesia (n=225). Sugammadex vs. No sugammadex (control) was evaluated on Discharge time (minutes) (p=0.0087). Sugammadex significantly shortened the median operation room discharge time to 18.6 minutes compared to 20.3 minutes in the control group following desflurane anesthesia lasting over 2 hours.
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