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

Spinal versus general anesthesia in retrograde intrarenal surgery

Aim: The indications for retrograde intrarenal surgery (RIRS) have greatly increased, however, there is still no consensus on the use of spinal anesthesia (SA) during this procedure. The aim of this study was to evaluate the comparability of surgical outcomes of RIRS performed under SA versus general GA for renal stones. Materials and methods: This was a retrospective, observational study in patients scheduled for RIRS in a single teaching hospital in Turkey. Inclusion criteria were age > 18 years and the presence of single or multiple renal stones. We recorded information concerning the site of lithiasis, the number of calculi, total stone burden, and the presence of concomitant ureteral stones or hydronephrosis. Results were evaluated in terms of surgical outcome, intraoperative and postoperative complications. Patients were followed-up until day 90 from discharge. Results: The data of 502 patients, 252 in GA group and 250 in SA group, were evaluated. The stone-free rate was 81% in the GA group and 85% in the SA group (p = 0.12). No cases of conversion from SA to GA were recorded. Complication rates were similar in the 2 groups (19% vs 14.5%, p = 0.15). Conclusions: In our cohort, RIRS performed under SA and GA was equivalent in terms of surgical results and complications