Effect of Sugammadex on Coagulation Parameters in Cesarean Section Patients a Prospective Controlled Observational Study


Abstract views: 70 / PDF downloads: 70

Authors

  • Emre Destegül Department of Obstetrics and Gynecology, Nig˘de O¨mer Halisdemir University Medical Faculty Training and Research Hospital, Nig˘de, Turkey https://orcid.org/0000-0001-5726-0223
  • Dilek Destegül Department of Anesthesiology and Reanimation, Nig˘de O¨mer Halisdemir University Faculty of Medicine, Training and Research Hospital, Nig˘de, Turkey https://orcid.org/0000-0003-4363-6239
  • Fazilet Kocaöz Department of Anesthesiology and Reanimation, Nig˘de O¨mer Halisdemir University Faculty of Medicine, Training and Research Hospital, Nig˘de, Turkey https://orcid.org/0000-0002-5418-6707

DOI:

https://doi.org/10.5152/eurjther.2021.21003

Keywords:

Cesarean section, coagulation, sugammadex, aPTT, neostigmin, postpartum bleeding

Abstract

Objective: To evaluate, for the first time in the literature, the effect of sugammadex in elective C/S patients in terms of hemostatic parameters and postoperative bleeding. Methods: Seventy-six patients enrolled for this observational prospective controlled study. Patients were divided into two groups according to anesthetic reversal agent: sugammadex (group I) vs neostigmin (group II). Intraoperative and postoperative amount of bleeding were recorded. At the end of the surgery, after administration of reversal agent, and at postoperative 30th minute, 1st, and 2nd hours, activated partial thromboplastin time (aPTT), prothrombin time (PT), and international normalized ratio (INR) values were recorded. Postoperative Hct, Hgb, and Plt values at 6th and 24th hours of reversal agent administration were also recorded. Results: Alterations in aPTT, PT, and INR values were similar between the groups (P ¼ .986, .549, .05, respectively). Conclusion: Sugammadex at 2 mg kg1 in cesarean section patients has a similar effect on coagulation parameters compared to neostigmin. Further studies are needed particularly in patients under thromboprophylaxis.

Metrics

Metrics Loading ...

References

Hellgren M. Hemostasis during normal pregnancy and puerperium. Semin Thromb Hemost. 2003;29:125-130.

Brenner B. Haemostatic changes in pregnancy. Thromb Res. 2004;114:409-414.

O’Riordan MN, Higgins JR. Haemostasis in normal and abnormal pregnancy. Best Pract Res Clin Obstet Gynaecol. 2003;17:385-396.

Franchini M. Haemostasis and pregnancy. Thromb Haemost. 2006;95:401-413.

Stirling Y, Woolf L, North WR, Seghatchian MJ, Meade TW. Haemostasis in normal pregnancy. Thromb Haemost. 1984;52:176-182.

Bonnar J. Haemostasis and coagulation disorders in pregnancy. In Bloom AL, Thomas DP (eds.): Haemostasis and Thrombosis. Edinburgh: Churchill Livingstone, 1987: 570-584.

Letsky EA. Coagulation Problems during Pregnancy. Vol. 10. Edinburgh: Churchill Livingstone, 1985. 8. Greer IA. Haemostasis and thrombosis in pregnancy. In Bloom AL, Forbes CD, Thomas DP, Tuddenham EGD (eds.): Haemostasis and Thrombosis, 3rd ed. Edinburgh: Churchill Livingstone, 1994: 987-1015.

Kinsella SM, Winton AL, Mushambi MC, et al. Int J Obstet Anesth. 2015;24:356-374.

Plaud B, Debaene B, Donati F, Marty J. Residual paralysis after emergence from anesthesia. Anesthesiology. 2010;112:1013-1022.

Naguib M. Sugammadex: Another milestone in clinical neuromuscular pharmacology. Anesth Analg. 2007;104:575-581.

Gijsenbergh F, Ramael S, Houwing N, van Iersel T. First human exposure of Org 25969, a novel agent to reverse the action of

rocuronium bromide. Anesthesiology. 2005;103:695-703.

Adam JM, Bennett DJ, Bom A, et al. Cyclodextrin-derived host molecules as reversal agents for the neuromuscular blocker rocuronium bromide: Synthesis and structure-activity relationships. J Med Chem. 2002;45:1806-1816.

Gaszynski T, Szewczyk T, Gaszynski W. Randomized comparison of sugammadex and neostigmine for reversal of rocuronium-induced muscle relaxation in morbidly obese undergoing general anaesthesia. Br J Anaesth. 2012;108:236-239.

Stouracˇ P, Kosinova´ M, Ba´ rtı´kova´ I, et al. Sugammadex for active reversal of neuromuscular blockade induced by rocuronium for

cesarean delivery in general anesthesia series of case reports [in Czech]. Anest Intenziv Med. 2013;24:163-168.

Pu¨Hringer FK, Kristen P, Rex C. Sugammadex reversal of rocuronium-induced neuromuscular block in caesarean section

patients: A series of seven cases. Br J Anaesth. 2010;105:657-660.

Williamson RM, Mallaiah S, Barclay P. Rocuronium and sugammadex for rapid sequence induction of obstetric general anaesthesia. Acta Anaesthesiol Scand. 2011;55:694-699.

Shibusawa M, Ejima Y, Nishino R, Toyama H, Kurosawa S. Use of sugammadex in patients undergoing caesarean section using general anesthesia with rocuronium. Masui. 2012;61:805-809.

Nauheimer D, Kollath C, Geldner G. Modified rapid sequence induction for Caesarian sections: Case series on the use of rocuronium and sugammadex. Anaesthesist. 2012;61:691-695.

Rahe-Meyer N, Fennema H, Schulman S, et al. Effect of reversal of neuromuscular blockade with sugammadex versus usual care on

bleeding risk in a randomized study of surgical patients. Anesthesiology. 2014;121(5):969-977.

De Kam PJ, El Galta R, Kruithof AC, et al. No clinically relevant interaction between sugammadex and aspirin on platelet aggregation

and coagulation parameters. Int J Clin Pharmacol Ther. 2013;51:976-985.

De Kam PJ, Grobara P, Prohn M, et al. Effects of sugammadex on activated partial thromboplastin time and prothrombin time in

healthy subjects. Int J Clin Pharmacol Ther. 2014;52:227-236.

European Medicines Agency. Assessment report for bridion. Document Reference EMEA/CHMP/317523/2008. 2008.

Tas N, Korkmaz H, Yag˘ an O¨ , Korkmaz M. Effect of sugammadex on postoperative bleeding and coagulation parameters after septoplasty: A randomized prospective study. Med Sci Monit. 2015;21:2382-2386.

Raft J, Guerci P, Harter V, Fuchs-Buder T, Meistelman C. Biological evaluation of the effect of sugammadex on hemostasis and bleeding. Korean J Anesthesiol. 2015;68(1):17.

Summary of product characteristics. Bridion. 2014. Available at http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_

Product_Information/human/000885/WC500052310.pdf.

Downloads

Published

2023-01-19

How to Cite

Destegül, E., Destegül, D., & Kocaöz, F. (2023). Effect of Sugammadex on Coagulation Parameters in Cesarean Section Patients a Prospective Controlled Observational Study. European Journal of Therapeutics, 27(4), 293–298. https://doi.org/10.5152/eurjther.2021.21003

Issue

Section

Original Articles