TY - JOUR
TI - Effect of Sugammadex versus Neostigmine/Atropine Combination on Postoperative Cognitive Dysfunction after Elective Surgery
AU - Batistaki, C.
AU - Riga, M.
AU - Zafeiropoulou, F.
AU - Lyrakos, G.
AU - Kostopanagiotou, G.
AU - Matsota, P.
JO - Romanian Journal of Anaesthesia and Intensive Care
PY - 2017
VL - 45
TODO - 5
SP - 581-588
PB - SAGE Publications Inc.
SN - null
TODO - 10.1177/0310057X1704500508
TODO - atropine;  fentanyl;  midazolam;  morphine;  neostigmine;  nonsteroid antiinflammatory agent;  paracetamol;  propofol;  remifentanil;  rocuronium;  ropivacaine;  sevoflurane;  sugammadex;  atropine;  cholinergic receptor stimulating agent;  gamma cyclodextrin derivative;  muscarinic receptor blocking agent;  neostigmine;  sugammadex, adult;  anesthesia induction;  Article;  clock drawing test;  cognition;  controlled study;  double blind procedure;  drug dose titration;  elective surgery;  female;  general anesthesia;  hospital discharge;  human;  major clinical study;  male;  middle aged;  Mini Mental State Examination;  neuromuscular blocking;  patient controlled analgesia;  postoperative analgesia;  postoperative cognitive dysfunction;  prospective study;  randomized controlled trial;  cognitive defect;  comparative study;  elective surgery;  postoperative complication;  procedures, Adult;  Atropine;  Cognitive Dysfunction;  Double-Blind Method;  Elective Surgical Procedures;  Female;  gamma-Cyclodextrins;  Humans;  Male;  Middle Aged;  Muscarinic Antagonists;  Neostigmine;  Neuromuscular Blockade;  Parasympathomimetics;  Postoperative Complications
TODO - This study aimed to assess the effects of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. A randomised, double-blind controlled trial was carried out on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years of age. The Mini–Mental State Evaluation, clock-drawing test and the Isaacs Set test were used to assess cognitive function at three timepoints: 1) preoperatively, 2) one hour postoperatively, and 3) at discharge. The anaesthetic protocol was the same for all patients, except for the neuromuscular block reversal, which was administered by random allocation using either sugammadex or neostigmine/ atropine after the reappearance of T2 in the train-of-four sequence. POCD was defined as a decline ≥1 standard deviation in ≥2 cognitive tests. The incidence of POCD was similar in both groups at one hour postoperatively and at discharge (28% and 10%, in the neostigmine group, 23% and 5.4% in the sugammadex group, P=0.55 and 0.27 respectively). In relation to individual tests, a significant decline of clock-drawing test in the neostigmine group was observed at one hour postoperatively and at discharge. For the Isaacs Set test, a greater decline was found in the sugammadex group. These findings suggest that there are no clinically important differences in the incidence of POCD after neostigmine or sugammadex administration. © 2017 Australian Society of Anaesthetists.
ER -