Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery: A Randomized Controlled Study

Objective: The purpose of this study was to evaluate the safety and efficacy of sugammadex for fast-track surgery in children undergoing cardiac surgery.Design: This was a prospective, randomized, controlled clinical study.Setting: University hospital.Participants: The study comprised 60 children undergoing cardiac surgery.Interventions: The children in group S received sugammadex, 4 mg/kg, for reversal of neuromuscular block, and the children in group N received neostigmine, 30 mu g/kg, and atropine, 15 mu g/kg.Measurements and main results: The recovery time to a train-of-four of 0.9 and extubation time were significantly shorter in the group S than in group N (3.4 +/- 1.2 min v 76.2 +/- 20.5 min and 31.0 +/- 6.4 min v 125.2 +/- 21.6 min, respectively; p < 0.01). The heart rate after drug administration was higher in group S than in group N (102.7 +/- 9.4 beats/min v 96.9 +/- 8.5 beats/min; p = 0.03), whereas the mean arterial pressure after drug administration was similar in both groups. The length of hospital stay was shorter in group S (5.8 +/- 1.0 v 6.5 +/- 0.9 days; p = 0.03), and the hospitalization expenses were decreased in group S compared with that of group N ($1,036 +/- $114 v $1,286 +/- $187; p < 0.01). The incidence of postoperative atelectasis was less in group S than in group N (0 v 20%; p = 0.024).Conclusion: Sugammadex can shorten the extubation time and reduce the incidence of postoperative atelectasis, with fewer adverse events, in children undergoing cardiac surgery. It may be beneficial to use sugammadex for fast-track surgery in children undergoing cardiac surgery. (C) 2020 Elsevier Inc. All rights reserved.