The comparison of reversal of neuromuscular blockade in diabetic and non-diabetic patients

ABSTRACT Aim: In our study we aimed to compare the time of antagonism and intensity of effect of sugammadex which is used for antagonism of rocuronium on diabetic and non-diabetic patients. Methods: Included patients were divided into 2 groups: diabetic (n=21) and non-diabetic (n=20). All patients were premedicated. After arrival in the operating room, all patients were monitorised with Datex Ohmeda S/5 Avance and ECG (DII derivation), SPO2, SBP, DBP, MBP, respiratory rate, ETCO2, and inspiratory sevoflurane concentrations were recorded. Neuromuscular monitoring system was used. Anesthesia was induced with propofol 2 mg/kg and fentanyl 1 mcg/kg. After the loss of eyelid reflex the neuromuscular monitoring system automatically identified supramaximal stimulating currents and after that rocuronium 0,6 mg/kg was given. TOF stimulation with the supramaximal current were applied and by recording of second TOF value (TOF2) the patient was intubated. Anesthesia was maintained with 50% O2 + 50% air and sevoflurane of 1 MAC. TOF stimulation was applied and recorded every 20 seconds. Intraoperatively by return T2 rocuronium 0,15 mg/kg was given. T2i time was recorded as intubation time and T2d time was recorded as clinical effect time. At the end of the operation sugammadex 2 mg/kg was given. When TOF rate reached 0,9 patients were extubated and the time was recorded. Results: In our study intubation time in diabetics were 183,14±96,49 seconds whereas 155,10±42,41 seconds in nondiabetics. The clinical effect time were 2549,61±913,17 seconds in diabetics and 2208,95±475,00 seconds in nondiabetics. The time of TOF rate reaching 0,9 were 434,61±857,09 seconds in diabetics and 250,45±108,44 seconds in nondiabetics. There were no statistical significant difference between the two groups in intubation time, clinical effect time and time of TOF rate reaching 0,9. Conclusion: In conclusion we thought that sugammadex was an effective alternative for diabetic patients by reversing the effects of neuromuscular blocking agents and reducing problems in recovery period.. KEYWORDS: diabetes mellitus, neuromuscular blockade, postoperative residual curarisation, rocuronium bromure, sugammadex