Coagulation Effect of Sugammadex as Determined by Thromboelastography in a Randomized Controlled Study of Surgical Patients

Chang, Hae Wone; Lee, IL Ok; Kang, Hyoseok; Won, Young Ju; Lim, Young-seob

doi:10.7150/ijms.42563

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Int J Med Sci 2021; 18(6):1318-1324. doi:10.7150/ijms.42563 This issue Cite

Research Paper

Coagulation Effect of Sugammadex as Determined by Thromboelastography in a Randomized Controlled Study of Surgical Patients

Hae Wone Chang^1✉, IL Ok Lee², Hyoseok Kang¹, Young Ju Won², Young-seob Lim¹

1. Department of Anesthesiology and Pain Medicine, Eulji University Hospital, Seoul, Korea.
2. Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, Korea.

Citation:

Chang HW, Lee ILO, Kang H, Won YJ, Lim Ys. Coagulation Effect of Sugammadex as Determined by Thromboelastography in a Randomized Controlled Study of Surgical Patients. Int J Med Sci 2021; 18(6):1318-1324. doi:10.7150/ijms.42563. https://www.medsci.org/v18p1318.htm

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Abstract

Introduction: Sugammadex has been shown to be associated with prolongation of prothrombin time and activated partial thromboplastin time. However, it is not known whether it could be associated with enhancing postoperative hypocoagulation. The objective of this study was to analyze the effect of 4 mg/kg of sugammadex on thromboelastography (TEG) parameters in surgical patients.

Methods: After Institutional Review Board approval, a prospective double-blinded randomized controlled study was conducted between September 2016 and April 2017. Sixty adult patients scheduled for laparoscopic abdominal surgery were randomly allocated to receive either sugammadex 4 mg/kg (sugammadex group) or pyridostigmine 0.15 mg/kg in combination with glycopyrrolate 0.4 mg (control group) to reverse rocuronium-induced neuromuscular blockade at the completion of surgery. Blood samples were collected three time points; After the final suture of surgery (baseline) (T1), and at 10 min (T2) and 1 h (T3) after administration of the study drug. Whole blood was analyzed by TEG using TEG 5000 (Hemonetics Corp, Braintree, MA, USA). The primary endpoints were comparison of coagulation time (K, time to 20 mm clot amplitude), R (reaction time), alpha angle, and maximal amplitude (MA) between two groups.

Results: Coagulation time was significantly prolonged in sugammadex group after 10 min of the study drug administration compared to control group (mean value 1.3 ± 0.4 vs. 1.5 ± 0.4, P = 0.03). However, R, alpha angle and MA value were not different between two groups.

Conclusions: Sugammadex 4 mg/kg showed an increase in coagulation time in surgical patients. Physician should aware the potential enhancement of hypocoagulation by sugammadex in the setting of high risk of postoperative bleeding.

Keywords: Sugammadex, Coagulation, Thromboelastography, Laparoscopic surgery

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APA

Chang, H.W., Lee, IL.O., Kang, H., Won, Y.J., Lim, Y.s. (2021). Coagulation Effect of Sugammadex as Determined by Thromboelastography in a Randomized Controlled Study of Surgical Patients. International Journal of Medical Sciences, 18(6), 1318-1324. https://doi.org/10.7150/ijms.42563.

ACS

Chang, H.W.; Lee, IL.O.; Kang, H.; Won, Y.J.; Lim, Y.s. Coagulation Effect of Sugammadex as Determined by Thromboelastography in a Randomized Controlled Study of Surgical Patients. Int. J. Med. Sci. 2021, 18 (6), 1318-1324. DOI: 10.7150/ijms.42563.

NLM

CSE

Chang HW, Lee ILO, Kang H, Won YJ, Lim Ys. 2021. Coagulation Effect of Sugammadex as Determined by Thromboelastography in a Randomized Controlled Study of Surgical Patients. Int J Med Sci. 18(6):1318-1324.

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