Recovery from rocuronium with sugammadex in children premedicated with dexamethasone for prevention of postoperative nausea and vomiting

Sugammadex is a cyclodextrin specifically designed to reverse the action of rocuronium through encapsulation. Theoretically, it is possible that sugammadex can encapsulate cortisone. The primary outcome of the present study is to investigate any possible alteration in the efficacy of sugammadex as a reversal of rocuronium due to dexamethasone injection in children undergoing strabismus surgery. The secondary outcome is to assess any possible side effects of sugammadex in these groups of patients.
Methods
Patients were randomly divided by a closed envelope method into 2 groups 40 patients each. All children were subjected to standard controlled general anesthesia with ETT. Intravenous (IV) dexamethasone 0.5 mg·kg after induction of GA was given in group I (dex group), while IV metoclopramide 0.25 mg·kg was given for group II (met group) as prophylactic antiemetics.
Measurements
Duration after sugammadex injection to reach 90% TOF ratio was measured by TOF watch SX acceleromyography. Clinical duration of extubation after sugammadex injection was measured. Any signs of residual curarization, respiratory insufficiency or muscle weakness were recorded in the PACU for two hours postoperatively.
Results
Time to reach 90% TOF was statistically significantly higher in the dex group (60.11 ± 1.98 s) than the met group (23.11 ± 2.36 s) with a P value of 0.001. Clinical time of extubation after sugammadex was higher in the dex group (72.8 ± 2.23 s) than the met group (37.61 ± 2.45 s) with a P value of 0.0001.
Conclusions
The present study demonstrated that the interaction between sugammadex and dexamethasone may have a clinical effect on the duration of reversal of rocuronium.