Evaluation of the effects of Neostigmine versus Sugammadex on renal functions in laparoscopic cholecystectomy patients

Authors

Mostafa S Mansour, Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine - Menoufia University, Shibin el Kom, Menoufia, EgyptFollow
Ashraf M Eskandr, Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine - Menoufia University, Shibin el Kom, Menoufia, Egypt
Omnia S Nabih, Clinical Pathology National Liver Institute-Menoufia University, Shibin el Kom, Menoufia, Egypt
Hager N Akila, Anesthesia and Intensive Care -National Liver Institute-Menoufia University, Shibin el Kom, Menoufia, Egypt
Yasmeen A kamel, Anesthesia and Intensive Care -National Liver Institute-Menoufia University, Shibin el Kom, Menoufia, Egypt

Subject Area

Anesthesiology

Article Type

Original Study

Abstract

Objectives: Using more sensitive and specific assays, comparing the immediate effects of sugammadex against neostigmine on renal function in patients undergoing laparoscopic cholecystectomy (LC).

Background: Because of its affordable price and broad-spectrum reversal effect, neostigmine is the most commonly used antagonist for neuromuscular blockade. Sugammadex is a synthetically modified γ-cyclodextrin that has gained popularity due to its effective and quick reversal effect that blocks at any depth without waiting for a spontaneous reversal.

Methods: Two equal groups of sixty-four patients scheduled for LC with normal renal function, ASA I–II, and ages 20–55 were randomly assigned to receive either Sugammadex or Neostigmine. Pre- and post-operative measurements were made of the serum concentrations of urea, Cr, and neutrophil gelatinase-associated lipocalin (NGAL), as well as creatinine clearance and glomerular filtration rate (GFR).

Results: Demographic data, preoperative serum urea, creatinine, creatinine clearance, NGAL levels, and intraoperative hemodynamic parameters did not significantly differ between the two groups (p>0.05). The postoperative serum creatinine, GFR, and NGAL values were slightly increased in the N group without statistical significance between the two groups. There was a significant correlation between postoperative creatinine values with weight, sex, creatinine clearance, and GFR.

Conclusion: Although sugammadex has quicker reversal effect than neostigmine and has similar safety and efficacy on renal functions during LC, it is nevertheless regarded as a more promising innovative anesthetic than the previous drug generations. On the other hand, the NGAL test is more sensitive than creatinine since it is not impacted by age, sex, or body weight.

Recommended Citation

Mansour, Mostafa S; Eskandr, Ashraf M; Nabih, Omnia S; Akila, Hager N; and kamel, Yasmeen A (2024) "Evaluation of the effects of Neostigmine versus Sugammadex on renal functions in laparoscopic cholecystectomy patients," Menoufia Medical Journal: Vol. 37: Iss. 3, Article 13.
DOI: https://doi.org/10.59204/2314-6788.3282