Effect of saline flush on the onset time of sugammadex: A randomized clinical study

Aim: Several methods have been tried out to shorten the onset time of sugammadex. The objective of this study was to examine the effect of 20 mL saline flush administered immediately after sugammadex on its onset time by using train-of-four (TOF) monitoring.Methods: This study was initiated after obtaining the approval of the institutional Medical Research Ethics Committee. A total of 60 ASA I-II patients aged between 18-65 years scheduled for elective abdominal surgery in our hospital between August 2017 and January 2018, which would last 1-3 hours under general anesthesia, were enrolled in this study. Patients were randomly divided into two groups as Group S (saline flush group, n=30) and Group C (control group, n=30). Saline flush group received 2 mg/kg sugammadex and 20 ml isotonic saline flush immediately after sugammadex administration, while the control group received 2 mg/kg sugammadex only. TOF monitoring was used to assess neuromuscular block. Electrocardiography, oxygen saturation, noninvasive arterial pressure as well as acceleromyography values measured by TOF monitoring device were recorded and compared between the groups. All patients were continuously monitored intraoperatively and 30 minutes postoperatively.Results: Both groups were similar in terms of basic clinical characteristics and demographics. There was a statistically significant difference between the groups in terms of the time of TOF to reach 0.9 from 0.2. The mean time of TOF to reach 0.9 from 0.2 was lower in Saline flush group than in control group (85.4 vs 130.5 seconds; P=0.001).Conclusion: Our study demonstrated that 20 mL saline flush administered immediately after sugammadex shortened the onset time of sugammadex.