The Effect of Intravenous Dexamethasone on Sugammadex Reversal Time in Children Undergoing Adenotonsillectomy

Gulec, Ersel MD; Biricik, Ebru MD; Turktan, Mediha MD; Hatipoglu, Zehra MD; Unlugenc, Hakki MD

doi: 10.1213/ANE.0000000000001142
Pediatric Anesthesiology: Research Report

BACKGROUND: Dexamethasone has been shown to cause inhibition of sugammadex reversal in functionally innervated human muscle cells. In this prospective, double-blind, randomized, controlled study, we evaluated the effect of dexamethasone on the reversal time of sugammadex in children undergoing tonsillectomy and/or adenoidectomy.

METHODS: We recruited 60 patients with ASA physical status I to II, between the ages of 3 and 8 years, scheduled for elective tonsillectomy and/or adenoidectomy. After the induction of anesthesia, patients in group D received IV dexamethasone at a dose of 0.5 mg/kg within a total volume of 5 mL saline, whereas patients in group S received only 5 mL IV saline as the control group. At the end of surgery, all patients were given a single bolus dose (2 mg/kg) of sugammadex at reappearance of T2. Demographic data, hemodynamic variables, time to recovery (a train-of-four ratio of 0.9), time to tracheal extubation, and adverse effects were recorded.

RESULTS: There was no statistical significance between 2 groups in time to recovery and time to extubation. Time to recovery was 97.7 ± 23.9 seconds in group D and 91.1 ± 39.5 seconds in group S (P = 0.436; 95% confidence interval, −10.3 to 23.5). Time to extubation was 127.9 ± 23.2 seconds and 123.8 ± 38.7 seconds in group D and in group S, respectively (P = 0.612; 95% confidence interval, −11.9 to 20.05).

CONCLUSIONS: IV dexamethasone, given after induction of anesthesia, at a dose of 0.5 mg/kg, does not substantively affect the reversal time of sugammadex in pediatric patients undergoing adenoidectomy and/or tonsillectomy.

Published ahead of print January 14, 2016

From the Department of Anesthesia, Cukurova University Faculty of Medicine, Balcalı Hospital, Adana, Turkey.

Accepted for publication November 16, 2015.

Published ahead of print January 14, 2016

Funding: Institutional and departmental.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Ersel Gulec, MD, Department of Anesthesia, Cukurova University Faculty of Medicine, Balcalı Hospital, 01130, Adana, Turkey. Address e-mail to gulecersel@yahoo.com.

© 2016 International Anesthesia Research Society