EFFECT OF SUGAMMADEX AND NEOSTIGMINE ON BLOOD GLUCOSE LEVEL:A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Objectives: Sugammadex is offered as a recent alternative to cholinesterase inhibitors in reversing neuromuscular block. Sugammadex is a cyclodextrin molecule that is consisted of bounded sugar molecules. Given its chemical structure, sugammadex may increase blood glucose levels. We aimed to investigate the effect of sugammadex on blood glucose and compare sugammadex to the conventional reverse agent Neostigmine. Methods: Sixty patients undergoing medium-term abdominal surgery under general anesthesia were included in this study. The patients were randomly divided into two groups: Group N (n = 30) and Group S (n = 30). The dose of 50 μg/kg Neostigmine and 20 μg/kg atropine was administered for the patients in Group N and 2 mg/kg sugammadex was administered for the patients in Group S. Blood glucose levels were measured at 15 minutes before (T1) and at 30th minute of surgery (T2). Blood glucose levels were recorded 30 minutes (T3), 2 hours (T4) and 4 hours (T5) after administration of the reversing agent. Results: Blood glucose levels that were measured at T3, T4 and T5 were significantly higher in Group S compared to Group N (p<0.05). We consider that sugammadex contains glucose molecules and does not bind to plasma proteins, may cause an increase in blood glucose level and this increase may be associated with chemical structure of sugammadex rather than surgical stress of patients

Ultrasound-Guided Subclavian Vein Cannulation in Neonate via Supraclavicular Approach

Central venous cannulation of infants may be challenging. Ultrasonography is recommended and has been found superior to classic landmark technique in pediatric central venous cannulation. The cannulation of the subclavian vein using supraclavicular approach under real-time ultrasound guidance is a novel technique. It may have advantages over ultrasound-guided jugular vein cannulation in specific patients. We report a case of 3200-gram 20-day-old anencephalic neonate who had a diffuse generalized edema. The neonate was cannulated successfully via subclavian vein using supraclavicular approach under ultrasound guidance