Effects Of Sugammadex On Postoperative Respiratory Management And Reduction Of Ventilation-induced Lung Injury In Children With Congenital Heart Disease

Objective: To evaluate the effects of sugammadex on postoperative respiratory management and ventilation-induced lung injury in children with congenital heart disease.Methods: Forty pediatric patients with congenital heart disease,aged 1 to 6 years,ASA Ⅱ or III,weighing 7 to 25 kg,both sex were randomly assigned into two groups to receive 4 mg/kg sugammadex(Group S)or normal saline(Group C)postoperatively as a reversal agent for rocuronium when the muscle relaxation was monitored for post-tetanic count(PTC)=1 to 2 and train of four(TOF)= 0.The recovery time of TOF of 0.25,0.75 and 0.9,mechanical ventilation time and extubation time(from terminating anesthetics to extubation),hemodynamic parameters,and side effects after sugammadex administration were recorded.The arterial blood was drawn to analysis before and after extubation.The levels of C-reactive protein(CRP)and procalcitonin(PCT)before and 24 h after surgery were also measured.Results: The recovery time to TOF of 0.25,0.5 and 0.9,mechanical ventilation and extubation time were significantly shorter(P <0.01)in Group S than those in Group C(2.1±1.0 vs 80.8±22.6 min,3.4±1.4 vs97.5±20.9 min,4.6±1.8 vs 110.6±22.3 min,67.3±7.1 vs 181.5±23.5 min,68.8±7.9 vs 189.8±24.7 min,P <0.01).The levels of CRP and PCT significantly increased 24 hours after surgery in both groups,there were statistical differences in the levels of CRP and PCT at 24 hours after surgery between the two groups(median,7 vs 17.5 mg/L,1.76 vs 5.22ng/L,respectively,P <0.05).There were no statistical differences in terms of side effects between the two groups(P>0.05).Conclusion: Sugammadex is fast and effective in reversing rocuronium-induced neuromuscular block in children with congenital heart,and can decrease the duration of ventilation and the postoperative release of CRP and PCT.