Sugammadex Vs Neostigmine As A Reversal Agent In Patient Undergoing Thoracic Surgery Prospective randomized Observational Study

Neuromuscular blocking drugs are considered essential because they can facilitate airway instrumentation and improve surgical conditions. Residual neuromuscular block is associated with upper airway obstruction,hypoxaemia,atelectasis and pneumonia.Furthermore, even low levels of neuromuscular block (train-of-four [TOF] ratio <0.9 or <0.95) in healthy volunteers not exposed to anaesthesia or surgery was associated with pharyngeal and laryngeal dysfunction, and depressed hypoxic ventilatory drive.

Sugammadex is a modified gamma cyclodextrin, a selective binding agent that antagonizes neuromuscular blockade produced by amino steroid non-depolarizing muscle relaxants like rocuronium and vecuronium.

Compared to acetylcholinesterase inhibitors like neostigmine , sugammadex  is associated with a faster reversal of neuromuscular blockade. Patients undergoing thoracic surgeries require a deeper level of neuromuscular blockade to prevent diaphragmatic movement from interfering with the procedure and hence are at high risk of incomplete neuromuscular recovery and associated complications.Patient will be taken into OT , monitors attached , vital parameters like heart rate , SPO2 , Mean arterial pressure  and  blood pressure will be  monitored. Hemodynamic changes at the time of reversal  and time taken for emergence from anaesthesia and effectiveness of reversal post administration of Sugammadex ( 1.8 – 4.4mg/kg) will be assessed.