Emergence Agitation, Nasal Surgery
Conditions
Keywords
Sugamadex,, Neostigmine, anesthesia recovery, nasal surgery
Brief summary
The impact of sugammadex on agitation upon emergence following adult nasal surgeries is an issue which needs to be studied that links anesthetic management with postoperative recovery.
Detailed description
The included patients in the study will not be premedicated by sedatives, they will be preoxygenated for 5 minutes by 100% oxygen. The induction of anesthesia will be by fentanyl 100 microgram, 1.5 mg/kg lidocaine followed by propofol 2mg/kg, and rocuronium 0.5 mg/kg. oral intubation will be commenced and an oral pack will be inserted. Anesthesia will be maintained by sevoflurane 2% and N2O : O2 ratio of 50: 50. Hypotensive anesthesia will be conducted by labetalol 10- 20 mg i.v. At the end of surgery inhalational anesthesia will be abandoned and muscle relaxant will be antagonized either by sugamadex 1mg/kg or neostigmine 0.05 mg/kg mixed with atropine 0.02 mg/kg. After awakening of the of the patients, emergence agitation will be assessed by Agitation and Emergence Score (AES): This scale is ranging from 0 (calm and cooperative) to 4 (combative, aggressive behavior).
Interventions
Neostigmine group will receive the neostigmine as a reversal of the muscle relaxant; rocuronium
DRUGSugamadex
Sugamadex group will receive sugamadex as a reversal agent of the muscle relaxant; rocuronium Neostigmine group will receive the neostigmine as a reversal of the muscle relaxant; rocuronium. Both interventions will be used to compare the effect of adequate muscle relaxation upon the emergence agitation.
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Masking description
no need for masking
Intervention model description
Sugamadex group will receive sugamadex as a reversal agent of the muscle relaxant; rocuronium. the aim is to study the impact of adequate muscle relaxation upon the emergence agitation. This will be compared the neostigmine group which will receive it as a reversal agent of the muscle relaxation
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Adult patients aging from 18 to 60 years old, undergoing nasal surgeries such as septoplasty, FESS or Rhinoplasty * ASA I and ASA II
Exclusion criteria
* Patients receiving any medications which may affect recovery state e.g. Antipsychotics. * Smokers * Obstructive sleep apnea patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the incidence of emergence agitation following adult nasal surgeries in patients receiving sugammadex versus a traditional neuromuscular blocking agent reversal method. | perioperative | Agitation and Emergence Score (AES): This scale is ranging from 0 (calm and cooperative) to 4 (combative, aggressive behavior). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| duration to full consciousness | Perioperative | Minutes |
Countries
Saudi Arabia
Outcome results
None listed